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Cardiac Pharmacology: Difference between revisions
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|Hypertension: Class IA <cite>Esc2</cite> | |Hypertension: Class IA <cite>Esc2</cite> | ||
Hypertension in symptomatic (NYHA class II-IV) HF and LVD: Class IA <cite> | Hypertension in symptomatic (NYHA class II-IV) HF and LVD: Class IA <cite>Esc1</cite> | ||
Hypertension in diabetics: Class IA <cite> | Hypertension in diabetics: Class IA <cite>Esc3</cite> | ||
|rowspan="4" valign="top"|Hypotension (2.4%), renal impairment, persistent dry cough, angioedema, rash pancreatitis, upper respiratory-tract symptoms (2-10%), gastro-intestinal symptoms (1-2%), altered liver function tests, cholestatic jaundice, hepatitis, fulminant hepatic necrosis and failure, hyperkalaemia (2%), hypoglycaemia, blood disorders including thrombocytopenia, leucopenia, neutropenia, headache (3%), dizziness (2-12%), fatigue, malaise, taste disturbance, paraesthesia, bronchospasm, fever, serositis, vasculitis, myalgia (3%), arthralgia, positive antinuclear antibody, raised erythrocyte sedimentation rate, eosinophilia, leucocytosis, and photosensitivity. | |rowspan="4" valign="top"|Hypotension (2.4%), renal impairment, persistent dry cough, angioedema, rash pancreatitis, upper respiratory-tract symptoms (2-10%), gastro-intestinal symptoms (1-2%), altered liver function tests, cholestatic jaundice, hepatitis, fulminant hepatic necrosis and failure, hyperkalaemia (2%), hypoglycaemia, blood disorders including thrombocytopenia, leucopenia, neutropenia, headache (3%), dizziness (2-12%), fatigue, malaise, taste disturbance, paraesthesia, bronchospasm, fever, serositis, vasculitis, myalgia (3%), arthralgia, positive antinuclear antibody, raised erythrocyte sedimentation rate, eosinophilia, leucocytosis, and photosensitivity. | ||
|- | |- | ||
|Heart Failure | |Heart Failure | ||
|Captopril: 12.5mg 3 times daily | |Captopril: 12.5mg 3 times daily | ||
|Post STEMI: Class IA <cite> | |Post STEMI: Class IA <cite>Esc4</cite> | ||
Diabetic patients: Class IC <cite> | Diabetic patients: Class IC <cite>Esc2</cite> | ||
Symptomatic (NYHA class II-IV) HF: Class IA; Acute heart failure with ACS: Class IA <cite> | Symptomatic (NYHA class II-IV) HF: Class IA; Acute heart failure with ACS: Class IA <cite>Esc1</cite> | ||
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|Prophylaxis Following MI | |Prophylaxis Following MI | ||
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|Hypertension: Class IA <cite>Esc2</cite> | |Hypertension: Class IA <cite>Esc2</cite> | ||
Hypertension in diabetics: Class IA <cite> | Hypertension in diabetics: Class IA <cite>Esc3</cite> | ||
|rowspan="3" valign="top"|Gastro-intestinal disturbances (<3%), dizziness (14%), angina, palpitation, oedema, dyspnoea, headache (14%), malaise, urticaria, pruritus, rash; | |rowspan="3" valign="top"|Gastro-intestinal disturbances (<3%), dizziness (14%), angina, palpitation, oedema, dyspnoea, headache (14%), malaise, urticaria, pruritus, rash; | ||
|- | |- | ||
|Left ventricular hypertrophy | |Left ventricular hypertrophy | ||
|Losartan: 12.5-150mg daily | |Losartan: 12.5-150mg daily | ||
|LVH: Class IB <cite> | |LVH: Class IB <cite>Esc4</cite> | ||
|- | |- | ||
|Diabetic nephropathy | |Diabetic nephropathy | ||
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|Angina | |Angina | ||
|Atenolol: 100mg once/twice daily | |Atenolol: 100mg once/twice daily | ||
|ACS: Class IIaB <cite> | |ACS: Class IIaB <cite>Esc2</cite> | ||
Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IA <cite> | Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IA <cite>Esc1</cite> | ||
|- | |- | ||
|Arrhythmias | |Arrhythmias | ||
|Atenolol: 50-100mg daily | |Atenolol: 50-100mg daily | ||
|Atrial fibrillation: Class IA; Polymorphic VT: Class IB <cite> | |Atrial fibrillation: Class IA; Polymorphic VT: Class IB <cite>Esc4</cite> | ||
Symptomatic (NYHA class II-IV) HF, LVD and AF: Class IA; Management of VA in HF: Class IA <cite> | Symptomatic (NYHA class II-IV) HF, LVD and AF: Class IA; Management of VA in HF: Class IA <cite>Esc1</cite> | ||
SVT: Class IIbC; Wide QRS-complex tachycardia of unknown origin: Class IIIC; Sinus tachycardia: Class IC; Poorly tolerated AVNRT with haemodynamic intolerance: Class IIaC; Recurrent symptomatic AVNRT: Class IC; Documented PSVT with only dual AV-nodal pathways or single echo beats demonstrated during electrophysiological study and no other identified cause of arrhythmia: Class IC; Infrequent, well tolerated AVNRT: Class IB; Focal junction tachycardia: Class IIaC; Nonparoxysmal junctional tachycardia: Class IIaC; WPW Syndrome: Class IIaC; AVRT, poorly tolerated: Class IIbC; Since or infrequent AVRT episode(s): Class IIaB; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IC; AF (Poorly tolerated): Class IIaC; AF (Stable flutter): Class IC; Prophylaxis of SVT during pregnancy: Class IIaB <cite> | SVT: Class IIbC; Wide QRS-complex tachycardia of unknown origin: Class IIIC; Sinus tachycardia: Class IC; Poorly tolerated AVNRT with haemodynamic intolerance: Class IIaC; Recurrent symptomatic AVNRT: Class IC; Documented PSVT with only dual AV-nodal pathways or single echo beats demonstrated during electrophysiological study and no other identified cause of arrhythmia: Class IC; Infrequent, well tolerated AVNRT: Class IB; Focal junction tachycardia: Class IIaC; Nonparoxysmal junctional tachycardia: Class IIaC; WPW Syndrome: Class IIaC; AVRT, poorly tolerated: Class IIbC; Since or infrequent AVRT episode(s): Class IIaB; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IC; AF (Poorly tolerated): Class IIaC; AF (Stable flutter): Class IC; Prophylaxis of SVT during pregnancy: Class IIaB <cite>Acc5</cite> | ||
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|Migraine | |Migraine | ||
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|Hypertension | |Hypertension | ||
|Nifedipine: 20-30mg once daily | |Nifedipine: 20-30mg once daily | ||
|Hypertension in symptomatic (NYHA class II-IV) HF and LVD: Class IA <cite> | |Hypertension in symptomatic (NYHA class II-IV) HF and LVD: Class IA <cite>Esc1</cite> | ||
|rowspan="3" valign="top"|Gastro-intestinal disturbance (2-11%); hypotension (1-5%), oedema (7-29%), vasodilatation, palpitation; headache (7-35%), dizziness (3-27%), lethargy (4-6%), asthenia (10-12%); less commonly tachycardia (<1-7%), syncope (<1%), chills, nasal congestion, dyspnoea (<3%), anxiety, sleep disturbance (<2%), vertigo (<3%), migraine, paraesthesia, tremor (1-8%), polyuria, dysuria, nocturia, erectile dysfunction (<2%), epistaxis, myalgia, joint swelling, visual disturbance (<2%), sweating (<2%), hypersensitivity reactions (<1%); rarely anorexia, gum hyperplasia, mood disturbances, hyperglycaemia, male infertility, purpura (<1%), and photosensitivity reactions (<1%); also reported dysphagia, intestinal obstruction, intestinal ulcer, bezoar formation, gynaecomastia, agranulocytosis, and anaphylaxis; | |rowspan="3" valign="top"|Gastro-intestinal disturbance (2-11%); hypotension (1-5%), oedema (7-29%), vasodilatation, palpitation; headache (7-35%), dizziness (3-27%), lethargy (4-6%), asthenia (10-12%); less commonly tachycardia (<1-7%), syncope (<1%), chills, nasal congestion, dyspnoea (<3%), anxiety, sleep disturbance (<2%), vertigo (<3%), migraine, paraesthesia, tremor (1-8%), polyuria, dysuria, nocturia, erectile dysfunction (<2%), epistaxis, myalgia, joint swelling, visual disturbance (<2%), sweating (<2%), hypersensitivity reactions (<1%); rarely anorexia, gum hyperplasia, mood disturbances, hyperglycaemia, male infertility, purpura (<1%), and photosensitivity reactions (<1%); also reported dysphagia, intestinal obstruction, intestinal ulcer, bezoar formation, gynaecomastia, agranulocytosis, and anaphylaxis; | ||
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|Angina (prophylaxis) | |Angina (prophylaxis) | ||
|Nifedipine: 5-20mg 3 times daily | |Nifedipine: 5-20mg 3 times daily | ||
|Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IIaA <cite> | |Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IIaA <cite>Esc1</cite> | ||
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|colspan="6" bgcolor="#E6E6FA"|'''Anti-Arrhythmics''' | |colspan="6" bgcolor="#E6E6FA"|'''Anti-Arrhythmics''' | ||
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|Ventricular Arrhythmias | |Ventricular Arrhythmias | ||
|Flecainide: 50-100mg twice daily | |Flecainide: 50-100mg twice daily | ||
|Sustained VT and VF: Class IIbC <cite> | |Sustained VT and VF: Class IIbC <cite>Esc4</cite> | ||
Pre-excited SVT/AF: Class IB; Wide QRS-complex tachycardia of unknown origin: Lidocaine (Class IIbB) / Procainamide (Class IB); Wide QRS-complex tachycardia of unknown origin with LVD: Class IB; Focal junction tachycardia: Class IIaC; WPW Syndrome: IIaC; AVRT, poorly tolerated: IIaC; Single or infrequent AVRT episode(s): Class IIbC; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IIaC; AF (Stable flutter): Class IIbA; Prophylaxis of SVT during pregnancy: Class IIbB <cite> | Pre-excited SVT/AF: Class IB; Wide QRS-complex tachycardia of unknown origin: Lidocaine (Class IIbB) / Procainamide (Class IB); Wide QRS-complex tachycardia of unknown origin with LVD: Class IB; Focal junction tachycardia: Class IIaC; WPW Syndrome: IIaC; AVRT, poorly tolerated: IIaC; Single or infrequent AVRT episode(s): Class IIbC; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IIaC; AF (Stable flutter): Class IIbA; Prophylaxis of SVT during pregnancy: Class IIbB <cite>Acc5</cite> | ||
|Oedema, pro-arrhythmic effects (1-13%); dyspnoea; nervous-system side-effects including dizziness, asthenia, fatigue, fever; visual disturbances (13-28%); rarely pneumonitis, hallucinations, depression, confusion, amnesia, dyskinesia, convulsions, peripheral neuropathy; also reported gastro-intestinal disturbances (1-4%), anorexia, hepatic dysfunction, flushing, syncope, drowsiness, tremor, vertigo, headache, anxiety, insomnia, ataxia, paraesthesia, anaemia, leucopenia, thrombocytopenia, corneal deposits, tinnitus, increased antinuclear antibodies, hypersensitivity reactions (including rash, urticaria, and photosensitivity), increased sweating. | |Oedema, pro-arrhythmic effects (1-13%); dyspnoea; nervous-system side-effects including dizziness, asthenia, fatigue, fever; visual disturbances (13-28%); rarely pneumonitis, hallucinations, depression, confusion, amnesia, dyskinesia, convulsions, peripheral neuropathy; also reported gastro-intestinal disturbances (1-4%), anorexia, hepatic dysfunction, flushing, syncope, drowsiness, tremor, vertigo, headache, anxiety, insomnia, ataxia, paraesthesia, anaemia, leucopenia, thrombocytopenia, corneal deposits, tinnitus, increased antinuclear antibodies, hypersensitivity reactions (including rash, urticaria, and photosensitivity), increased sweating. | ||
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|Ventricular, Arrhythmias | |Ventricular, Arrhythmias | ||
|Amiodarone: 200mg 2-3 times daily | |Amiodarone: 200mg 2-3 times daily | ||
|Sustained VT and VF: Class IIaC; Polymorphic VT: Class IC <cite> | |Sustained VT and VF: Class IIaC; Polymorphic VT: Class IC <cite>Esc4</cite> | ||
Management of VA in HF: Class IA; Prevention of VA in HF: Class IIbB <cite> | Management of VA in HF: Class IA; Prevention of VA in HF: Class IIbB <cite>Esc1</cite> | ||
SVT: Class IIBC; Wide QRS-complex tachycardia of unknown origin: Class IB; Wide QRS-complex tachycardia of unknown origin with LVD: Class IB; Recurrent AVNRT unresponsive to beta blocker or calcium-channel blocker and patient not desiring RF ablation: Class IIbC; Focal junction tachycardia: Class IIaC; WPW Syndrome: IIaC; AVRT, poorly tolerated: Class IIaC; Since or infrequent AVRT episode(s): Class IIbB; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IIaC; AF (Poorly tolerated): Class IIbC; AF (Stable flutter): Class IIbC; Prophylaxis of SVT during pregnancy: Class IIIC <cite> | SVT: Class IIBC; Wide QRS-complex tachycardia of unknown origin: Class IB; Wide QRS-complex tachycardia of unknown origin with LVD: Class IB; Recurrent AVNRT unresponsive to beta blocker or calcium-channel blocker and patient not desiring RF ablation: Class IIbC; Focal junction tachycardia: Class IIaC; WPW Syndrome: IIaC; AVRT, poorly tolerated: Class IIaC; Since or infrequent AVRT episode(s): Class IIbB; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IIaC; AF (Poorly tolerated): Class IIbC; AF (Stable flutter): Class IIbC; Prophylaxis of SVT during pregnancy: Class IIIC <cite>Acc5</cite> | ||
|Gastro-intestinal disturbances (2-20%)), taste disturbances, hepatic disturbances (up to 50%); bradycardia; pulmonary toxicity (1-17%); tremor (9-59%), sleep disorders; hypothyroidism (5-10%), hyperthyroidism (5-10%); reversible corneal microdeposits (up to 98%); phototoxicity, persistent slate-grey skin discoloration (1-7%), injection-site reactions; less commonly onset or worsening of arrhythmia, conduction disturbances, peripheral neuropathy (1-105) and myopathy; very rarely sinus arrest, bronchospasm, ataxia (2-37%), benign intracranial hypertension, headache, vertigo, epididymo-orchitis, impotence, haemolytic or aplastic anaemia, thrombocytopenia, rash, hypersensitivity including photosensitivity (2-20%), anaphylaxis on rapid injection, hypotension (10-30%), respiratory distress syndrome, sweating, and hot flushes | |Gastro-intestinal disturbances (2-20%)), taste disturbances, hepatic disturbances (up to 50%); bradycardia; pulmonary toxicity (1-17%); tremor (9-59%), sleep disorders; hypothyroidism (5-10%), hyperthyroidism (5-10%); reversible corneal microdeposits (up to 98%); phototoxicity, persistent slate-grey skin discoloration (1-7%), injection-site reactions; less commonly onset or worsening of arrhythmia, conduction disturbances, peripheral neuropathy (1-105) and myopathy; very rarely sinus arrest, bronchospasm, ataxia (2-37%), benign intracranial hypertension, headache, vertigo, epididymo-orchitis, impotence, haemolytic or aplastic anaemia, thrombocytopenia, rash, hypersensitivity including photosensitivity (2-20%), anaphylaxis on rapid injection, hypotension (10-30%), respiratory distress syndrome, sweating, and hot flushes | ||
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|Supra-ventricular Arrhythmias | |Supra-ventricular Arrhythmias | ||
|Acute: 0.75-1.5mg over 24 hours; Maintenance: 125-150µg daily | |Acute: 0.75-1.5mg over 24 hours; Maintenance: 125-150µg daily | ||
|SVT: Class IIbC; WPW Syndrome: Class IIIC; AVRT, poorly tolerated: Class IIIC; Since or infrequent AVRT episode(s): Class IIIC; Prophylaxis of SVT during pregnancy: Class IC <cite> | |SVT: Class IIbC; WPW Syndrome: Class IIIC; AVRT, poorly tolerated: Class IIIC; Since or infrequent AVRT episode(s): Class IIIC; Prophylaxis of SVT during pregnancy: Class IC <cite>Acc5</cite> | ||
|rowspan="3" valign="top"|Gastro-intestinal disturbances (vomiting, diarrhoea, anorexia, abdominal pain) (25%); arrhythmias (up to 50%), AV conduction disturbances (50%); nervous system disturbances (dizziness, apathy, confusion, headache, fatigue, weakness) (25%); blurred or yellow vision; rash, eosinophilia, depression, anorexia, intestinal ischaemia and necrosis, psychosis, gynaecomastia on long-term use, and thrombocytopenia. | |rowspan="3" valign="top"|Gastro-intestinal disturbances (vomiting, diarrhoea, anorexia, abdominal pain) (25%); arrhythmias (up to 50%), AV conduction disturbances (50%); nervous system disturbances (dizziness, apathy, confusion, headache, fatigue, weakness) (25%); blurred or yellow vision; rash, eosinophilia, depression, anorexia, intestinal ischaemia and necrosis, psychosis, gynaecomastia on long-term use, and thrombocytopenia. | ||
|- | |- | ||
|Heart Failure | |Heart Failure | ||
|62.5-125 µg daily | |62.5-125 µg daily | ||
|Symptomatic (NYHA class II-IV) HF: Class IIbB | |Symptomatic (NYHA class II-IV) HF: Class IIbB | ||
Symptomatic (NYHA class II-IV) HF, LVD and AF: Class IB; Acute HF with AF and VT: Class IC <cite> | Symptomatic (NYHA class II-IV) HF, LVD and AF: Class IB; Acute HF with AF and VT: Class IC <cite>Esc1</cite> | ||
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|colspan="6" bgcolor="#E6E6FA"|'''Anti-platelet Drugs''' | |colspan="6" bgcolor="#E6E6FA"|'''Anti-platelet Drugs''' | ||
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|Prevention of thrombotic cerebro- or cardio-vascular disease | |Prevention of thrombotic cerebro- or cardio-vascular disease | ||
|75mg once/day | |75mg once/day | ||
|Prevention in AF: Class IC; Prevention in diabetic patients: IIaB <cite> | |Prevention in AF: Class IC; Prevention in diabetic patients: IIaB <cite>Esc2</cite> | ||
Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite> | Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite>Esc1</cite> | ||
Prevention in hypertensive patients with CV events: Class IA; Prevention in hypertensive patients without CV history but with reduced renal function/high risk: Class IIbA <cite> | Prevention in hypertensive patients with CV events: Class IA; Prevention in hypertensive patients without CV history but with reduced renal function/high risk: Class IIbA <cite>Esc3</cite> | ||
Post-MI: Class Ia <cite> | Post-MI: Class Ia <cite>Esc3</cite> | ||
|rowspan="2" valign="top"|Bronchospasm (10-30% in asthmatics); gastro-intestinal irritation (up to 83%), gastro-intestinal haemorrhage (occasionally major), also other haemorrhage (e.g. intracranial (0.5%), subconjunctival), chest pain (8.3%), oedema (4.5%), hypertension (4.3%). | |rowspan="2" valign="top"|Bronchospasm (10-30% in asthmatics); gastro-intestinal irritation (up to 83%), gastro-intestinal haemorrhage (occasionally major), also other haemorrhage (e.g. intracranial (0.5%), subconjunctival), chest pain (8.3%), oedema (4.5%), hypertension (4.3%). | ||
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|Prevention of thrombotic events (esp. when warfarin not tolerated) | |Prevention of thrombotic events (esp. when warfarin not tolerated) | ||
|75mg once/day | |75mg once/day | ||
|Prevention in diabetic patients: IIaB; Primary and secondary prevention of stroke: Class IB <cite> | |Prevention in diabetic patients: IIaB; Primary and secondary prevention of stroke: Class IB <cite>Esc2</cite> | ||
Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite> | Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite>Esc1</cite> | ||
Acute phase of coronary artery syndrome: Class IB; Non-cardioembolic cerebral ischaemic events: Class IA <cite> | Acute phase of coronary artery syndrome: Class IB; Non-cardioembolic cerebral ischaemic events: Class IA <cite>Esc3</cite> | ||
|rowspan="3" valign="top"|Dyspepsia (5.2%), abdominal pain (5.6%), diarrhoea (4.5%); bleeding disorders including gastro-intestinal (2.0%) and intracranial (0.4%), nausea (3.4%), vomiting, gastritis, flatulence, constipation, gastric and duodenal ulcers, headache (7.6%), epistaxis (2.9%), dizziness (6.2%), paraesthesia, leucopenia, decreased platelets (very rarely severe thrombocytopenia), eosinophilia, rash (4.2%), pruritus (3.3%), vertigo, colitis, pancreatitis, hepatitis (<1%), acute liver failure, hypertension (4.3%), chest pain (8.3%), oedema (4.1%), vasculitis, confusion, hallucinations, taste disturbance, cough (3.9%), fatigue (4.8%) stomatitis, bronchospasm, interstitial pneumonitis, pyrexia (2.2%), blood disorders including thrombocytopenic purpura (5.3%), agranulocytosis, neutropenia (0.04%) and pancytopenia and hypersensitivity-like reactions (<0.1%)including fever, glomerulonephritis, arthralgia, Stevens-Johnson syndrome, toxic epidermal necrolysis, lichen planus. | |rowspan="3" valign="top"|Dyspepsia (5.2%), abdominal pain (5.6%), diarrhoea (4.5%); bleeding disorders including gastro-intestinal (2.0%) and intracranial (0.4%), nausea (3.4%), vomiting, gastritis, flatulence, constipation, gastric and duodenal ulcers, headache (7.6%), epistaxis (2.9%), dizziness (6.2%), paraesthesia, leucopenia, decreased platelets (very rarely severe thrombocytopenia), eosinophilia, rash (4.2%), pruritus (3.3%), vertigo, colitis, pancreatitis, hepatitis (<1%), acute liver failure, hypertension (4.3%), chest pain (8.3%), oedema (4.1%), vasculitis, confusion, hallucinations, taste disturbance, cough (3.9%), fatigue (4.8%) stomatitis, bronchospasm, interstitial pneumonitis, pyrexia (2.2%), blood disorders including thrombocytopenic purpura (5.3%), agranulocytosis, neutropenia (0.04%) and pancytopenia and hypersensitivity-like reactions (<0.1%)including fever, glomerulonephritis, arthralgia, Stevens-Johnson syndrome, toxic epidermal necrolysis, lichen planus. | ||
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|Acute myocardial infarction | |Acute myocardial infarction | ||
|300mg daily initially then 75mg once/day | |300mg daily initially then 75mg once/day | ||
|Post STEMI: Class IA <cite> | |Post STEMI: Class IA <cite>Esc4</cite> | ||
|- | |- | ||
|Acute coronary syndrome | |Acute coronary syndrome | ||
|300mg daily initially then 75mg once/day | |300mg daily initially then 75mg once/day | ||
|ACS: Class IIaC <cite> | |ACS: Class IIaC <cite>Esc2</cite> | ||
|- | |- | ||
|Prasugrel | |Prasugrel | ||
|Prevention of thrombotic events. | |Prevention of thrombotic events. | ||
|60mg bolus then 5-10mg once daily | |60mg bolus then 5-10mg once daily | ||
|Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite> | |Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite>Esc1</cite> | ||
Acute phase of coronary artery syndrome: Class IB <cite> | Acute phase of coronary artery syndrome: Class IB <cite>Esc3</cite> | ||
|Haemorrhage (11.3%) (including gastro-intestinal (1.5%) and intracranial), haematoma, haematuria, hypertension (7.5%), hypotension (3.9%), headache (5.5%), back pain (5.0%), dyspnoea (4.9%), nausea (4.6%), dizziness (4.1%), cough (3.9%), fatigue (3.7%), chest pain (3.1%), arrhythmias including atrial fibrillation (2.9%) and bradycardia (2.9%), rash (2.8%), pyrexia (2.7%), oedema (2.7%), diarrhoea (2.3%), hypercholesterolaemia/hyperlipidaemia (7.5%), anaemia, rash,hypersensitivity reactions including angioedema (0.06%), thrombocytopenia (0.06%), thrombotic thrombocytopenic purpura. | |Haemorrhage (11.3%) (including gastro-intestinal (1.5%) and intracranial), haematoma, haematuria, hypertension (7.5%), hypotension (3.9%), headache (5.5%), back pain (5.0%), dyspnoea (4.9%), nausea (4.6%), dizziness (4.1%), cough (3.9%), fatigue (3.7%), chest pain (3.1%), arrhythmias including atrial fibrillation (2.9%) and bradycardia (2.9%), rash (2.8%), pyrexia (2.7%), oedema (2.7%), diarrhoea (2.3%), hypercholesterolaemia/hyperlipidaemia (7.5%), anaemia, rash,hypersensitivity reactions including angioedema (0.06%), thrombocytopenia (0.06%), thrombotic thrombocytopenic purpura. | ||
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|Prevention of thrombotic events. | |Prevention of thrombotic events. | ||
|180mg bolus then 90mg twice daily | |180mg bolus then 90mg twice daily | ||
|Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite> | |Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA <cite>Esc1</cite> | ||
Acute phase of coronary artery syndrome: Class IB <cite> | Acute phase of coronary artery syndrome: Class IB <cite>Esc3</cite> | ||
|Dyspnoea (13.8%), haemorrhage, bruising; nausea (4.3%), vomiting, diarrhoea (3.7%), hypertension (3.8%), hypotension (3.2%), back pain (3.6%), abdominal pain, dyspepsia, gastritis, dizziness (4.5%), chest pain (3.7%), headache (6.5%), cough (4.9%), rash, pruritus, fatigue (3.2%), constipation, arrhythmias including atrial fibrillation (4.2%), paraesthesia, confusion, hyperuricaemia, raised serum creatinine (7.4%), vertigo. | |Dyspnoea (13.8%), haemorrhage, bruising; nausea (4.3%), vomiting, diarrhoea (3.7%), hypertension (3.8%), hypotension (3.2%), back pain (3.6%), abdominal pain, dyspepsia, gastritis, dizziness (4.5%), chest pain (3.7%), headache (6.5%), cough (4.9%), rash, pruritus, fatigue (3.2%), constipation, arrhythmias including atrial fibrillation (4.2%), paraesthesia, confusion, hyperuricaemia, raised serum creatinine (7.4%), vertigo. | ||
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|Primary hyper-cholesterolaemia, combined hyperlipidaemia | |Primary hyper-cholesterolaemia, combined hyperlipidaemia | ||
|Simvastatin: 10-20mg once daily | |Simvastatin: 10-20mg once daily | ||
|Dyslipidaemia: Class IA; Low HDL-C: Class IIbB; Elderly patients with CVD: IB; Elderly patients with no CVD but CV risk factors: IIbB; Type I diabetes: IC; Patients with CKD: IIaC; Transplant patients: Class IIaB; PAD: Class IA; HIV patients: IIaC <cite> | |Dyslipidaemia: Class IA; Low HDL-C: Class IIbB; Elderly patients with CVD: IB; Elderly patients with no CVD but CV risk factors: IIbB; Type I diabetes: IC; Patients with CKD: IIaC; Transplant patients: Class IIaB; PAD: Class IA; HIV patients: IIaC <cite>Esc2</cite> | ||
Hypertension in diabetics: Class IA; ACS: Class IA <cite> | Hypertension in diabetics: Class IA; ACS: Class IA <cite>Esc3</cite> | ||
|rowspan="3" valign="top"|Oedema (2.7%), abdominal pain (5.9%), nausea (5.4%), atrial fibrillation (5.7%), constipation (2.2%), gastritis (4.9%), diabetes mellitus (4.2%), myalgia (3.7%), headache (2.5%), insomnia (4.0%), vertigo (4.5%), bronchitis (6.6%), sinusitis (2.3%), eczema (4.5%), urinary tract infection (3.2%) | |rowspan="3" valign="top"|Oedema (2.7%), abdominal pain (5.9%), nausea (5.4%), atrial fibrillation (5.7%), constipation (2.2%), gastritis (4.9%), diabetes mellitus (4.2%), myalgia (3.7%), headache (2.5%), insomnia (4.0%), vertigo (4.5%), bronchitis (6.6%), sinusitis (2.3%), eczema (4.5%), urinary tract infection (3.2%) | ||
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|Familial hyper-cholesterolaemia | |Familial hyper-cholesterolaemia | ||
|Simvastatin: 40mg once daily | |Simvastatin: 40mg once daily | ||
|HeFH: Class IC <cite> | |HeFH: Class IC <cite>Esc2</cite> | ||
|- | |- | ||
|Prevention of cardiovascular events | |Prevention of cardiovascular events | ||
|20-40mg once daily | |20-40mg once daily | ||
|Class IA <cite> | |Class IA <cite>Esc2</cite> | ||
|- | |- | ||
|rowspan="2"|Fibrates | |rowspan="2"|Fibrates | ||
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|Hyperlipidaemias of types IIa, IIb, III, IV and V | |Hyperlipidaemias of types IIa, IIb, III, IV and V | ||
|Gemfibrozil: 0.9-1.2mg daily | |Gemfibrozil: 0.9-1.2mg daily | ||
|Low HDL-C: Class IIbB; Transplant patients (with HTG, low HDL-C): Class IIbC <cite> | |Low HDL-C: Class IIbB; Transplant patients (with HTG, low HDL-C): Class IIbC <cite>Esc6</cite> | ||
|Gastro-intestinal disturbances including dyspepsia (19.6%), nausea (4%), abdominal pain (9.8%), diarrhoea (7.2%), vomiting (1.2%); headache (1.2%), fatigue (3.8%), vertigo (1.5%), eczema, rash (1.7%), atrial fibrillation (0.7%), pancreatitis, appendicitis, disturbances in liver function including hepatitis and cholestatic jaundice, dizziness, paraesthesia, sexual dysfunction, thrombocytopenia, anaemia, leucopenia, eosinophilia, bone-marrow suppression, myalgia, myopathy, myasthenia, myositis accompanied by increase in creatine kinase, blurred vision, exfoliative dermatitis, alopecia, and photosensitivity | |Gastro-intestinal disturbances including dyspepsia (19.6%), nausea (4%), abdominal pain (9.8%), diarrhoea (7.2%), vomiting (1.2%); headache (1.2%), fatigue (3.8%), vertigo (1.5%), eczema, rash (1.7%), atrial fibrillation (0.7%), pancreatitis, appendicitis, disturbances in liver function including hepatitis and cholestatic jaundice, dizziness, paraesthesia, sexual dysfunction, thrombocytopenia, anaemia, leucopenia, eosinophilia, bone-marrow suppression, myalgia, myopathy, myasthenia, myositis accompanied by increase in creatine kinase, blurred vision, exfoliative dermatitis, alopecia, and photosensitivity | ||
|- | |- | ||
| Line 589: | Line 589: | ||
|Primary and familial hyper-cholesterolaemia | |Primary and familial hyper-cholesterolaemia | ||
|10mg once daily | |10mg once daily | ||
|Transplant patients (with high LDL-C): Class IIbC <cite> | |Transplant patients (with high LDL-C): Class IIbC <cite>Esc6</cite> | ||
|Gastro-intestinal disturbance including diarrhoea (4.1%) and abdominal pain (3.0%); headache, fatigue (2.4%); myalgia, arthralgia (3.0%), sinusitis (3.6%), pharyngitis (2.3%), viral infection (2.2%), coughing (2.3%), hypersensitivity reactions including rash, angioedema, and anaphylaxis, hepatitis,pancreatitis, cholelithiasis, cholecystitis, thrombocytopenia, raised creatine kinase, myopathy, and rhabdomyolysis | |Gastro-intestinal disturbance including diarrhoea (4.1%) and abdominal pain (3.0%); headache, fatigue (2.4%); myalgia, arthralgia (3.0%), sinusitis (3.6%), pharyngitis (2.3%), viral infection (2.2%), coughing (2.3%), hypersensitivity reactions including rash, angioedema, and anaphylaxis, hepatitis,pancreatitis, cholelithiasis, cholecystitis, thrombocytopenia, raised creatine kinase, myopathy, and rhabdomyolysis | ||
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