NHS Bath and North East Somerset, Swindon and Wiltshire CCG Royal United Hospitals Bath NHS Foundation Trust Great Western Hospitals NHS Foundation Trust Salisbury NHS Foundation Trust
Initiated by a cardiologist in line with NICE and also for patients who otherwise would be treated with clopidogrel but who are intolerant/allergic to clopidogrel.
The treatment period for prasugrel should not exceed 12 months.
Prasugrel should not be used in patients at increased risk of bleeding, in patients who are 75 years or older or body weight less than 60kg
Prasugrel in combination with aspirin is recommended as an option for preventing blockages in the arteries of people with ACS who are having a PCI only when:
immediate PCI is necessary to treat an STEMI or
a blood clot has blocked a stent during treatment with clopidogrel or
Consultant cardiologist initiated in line with NICE TA below.
Treatment with ticagrelor will continue for 12 months
Ticagrelor in combination with aspirin is available as an alternative to prasugrel or clopidogrel for:
Patients allergic to clopidogrel and prasugrel
Patients that have had a stent thrombosis on prasugrel
Patients with resistance to treatment with clopidogrel and prasugreL
Patients with STEMI– defined as ST elevation or new left bundle branch block on electrocardiogram – that cardiologists intend to treat with primary percutaneous coronary intervention (PCI)
60mg tablets
Consultant cardiologist initiated in line with NICE TA below.
Used in combination with aspirin, it is recommended within its marketing authorisation as an option for preventing atherothrombotic events in adults who had a myocardial infarction and who are at high risk of a further event.
Treatment should be stopped when clinically indicated or at a maximum of 3 years
RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.
These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
Suitable for patient to be directed to buy themselves
Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.
Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.
