Box 1.
Which P2Y12 inhibitor to choose.62
| Choose: |
| > clopidogrel, when cost is an issue, there is a high risk of bleeding, in patients who have received thrombolysis, or in patients who need long-term oral anticoagulation |
| > ticagrelor (in preference to clopidogrel), in patients managed by an ischemia-guided or invasively treated patients |
| > prasugrel (in preference to clopidogrel), in patients undergoing PCI. |
| Avoid: |
| > clopidogrel, if CYP2C19*2 polymorphisms present, and in those who need to take PPIs, especially omeprazole or esomeprazole |
| >ticagrelor, if patients are receiving concomitant drugs which are strong inhibitors of CYP3A4 |
| >prasugrel, if patients had a history of stroke or TIA, age >75 years and body weight <60 kg. |
| PCI = percutaneous coronary intervention; PPIs = proton-pump inhibitors; TIA = transient ischaemic attack, |