Prevention of thrombotic events (CV death, MI, stroke) in patients w/ a history of ST-elevation MI (STEMI), non-ST-elevation MI (NSTEMI), & unstable angina including patients managed medically & managed w/ percutaneous coronary intervention (PCI) or CABG.
Dosage/Direction for Use
Loading dose: 180 mg. Maintenance dose: 90 mg bid beginning about 12 hr after loading dose in the morning & evening for 1 yr after acute coronary syndrome event. Concomitant use w/ aspirin: Administer w/ a loading dose of aspirin 300-325 mg followed by a maintenance dose of aspirin 75-100 mg daily.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity. History of intracranial hemorrhage, active bleeding, severe hepatic impairment.
Special Precautions
Increased risk of bleeding. Contraindicated in patients w/ active pathological bleeding. Manage bleeding if possible w/o discontinuing treatment. If discontinuation of treatment is necessary, resume as soon as possible after bleeding source is identified & controlled. Avoid maintenance dose of aspirin >100 mg/day. Avoid initiating treatment if urgent CABG surgery is planned. Discontinue use at least 5 days prior to any surgery; discontinue in patients unable to tolerate treatment-related dyspnea. Ventricular pauses & bradyarrhythmias including AV block.
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