Secondary prevention of atherothrombotic events in MI (few days until <35 days), ischaemic stroke (7 days until <6 mth) or established peripheral arterial disease. Acute coronary syndrome: In combination w/ ASA for non-ST segment elevation (unstable angina or non-Q-wave MI) including patients undergoing stent placement following percutaneous coronary intervention & ST segment elevation acute MI in medically treated patients eligible for thrombolytic therapy. In combination w/ ASA for prevention of atherothrombotic & thromboembolic events in atrial fibrillation including stroke.
History of hypersensitivity to other thienopyridines eg, ticlopidine or prasugrel. Discontinue use if acquired haemophilia is diagnosed. Not recommended during 1st 7 days after acute ischaemic stroke. Increased risk of bleeding from trauma, surgery or other pathological conditions; GI & intraocular lesions w/ propensity to bleed; TTP. Patients w/ genetically reduced CYP2C19 function. Not to be taken by patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Discontinue use 7 days prior to elective surgery. Not recommended in concomitant use w/ oral anticoagulants. Concomitant use w/ ASA, heparin, glycoprotein IIb/IIIa inhibitors or NSAIDS including COX-2 inhibitors, SSRIs or other medicinal products associated w/ bleeding risk eg, pentofylline; strong or moderate CYP2C19 inhibitors, CYP2C8 substrates. Renal impairment. Moderate hepatic disease w/ bleeding diatheses. Not to be used during pregnancy & lactation. Not to be used in childn.
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