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Stockport Health Authority
Springwood House
Poplar Grove
Stockport
SK7 5BY

26 September 2006

Class (BNF Code)

Main Indications

Drug Choice

Diuretics (2.2) - Thiazides

Hypertension

Bendrofluazide 2.5mg

- Loop Diuretics

Bumetanide where Oedema linked to right side failure

- Other Diuretics

Heart Failure

Spironolactone 25mg

Beta Blockers (2.4)

Hypertension

Angina

Post MI

Atenolol 50mg

Heart Failure

Bisoprolol Start Dose 2.5mg

Carvedilol Start Dose 3.125mg

Metoprolol Start Dose 5mg

ACE Inhibitors (2.5)

Hypertension

Trandolapril

Heart Failure

Cilazapril (or from above)

Angiotensin II

Receptor Antagonists

Hypertension

Valsartan (2^nd Choice)

Nitrates (2.6)

Angina

Isosorbide Mononitrate 10mg twice daily to start. Avoid slow release nitrates unless higher dose needed with compliance problems / side effects from peaks / more than twice daily needed.

Potassium Channel Activator (2.6)

Angina

Nicorandil – If Nicorandil used a nitrate prep may not be reqd

Calcium Channel Blockers (2.6)

Hypertension

Diltiazem (Generic 60mg, Tildium 90, 120, 200, 300mg)

Verapamil (Securon 120, 240mg)

Hypertension

where Angina or Heart Failure also

Amlodipine

Hypertension or Angina with Atrial Fibrillation

Verapamil or Diltiazem (as above)

Angina

Verapamil or Diltazem (as above)

Antiplatelet Drugs (2.9)

Secondary prevention of thrombotic cerebrovascular or cardiovascular disease

Aspirin 75mg (avoid E.C. preps)

Note: Mild – moderate GI Symptoms not normally a contraindication to aspirin

If aspirin contraindicated – Dipyridamole Slow Release to prevent TIA

Where Dipyridamole not tolerated or post MI where aspirin contra indicated – Clopidogrel

Statins

Lipid Lowering – Secondary prevention or primary prevention

Additionally:

Simvastatin