Anti-platelet medications

SJH Theatres and Anaesthetics
NHS Lothian

Anti-platelet medication

Anti-platelet drugs are used in the secondary prevention of cardiovascular disease. Examples include clopidogrel after stroke or TIA, dual antiplatelet therapy with aspirin plus (most commonly) clopidogrel after acute coronary syndromes (ACS) and particularly after coronary stenting.

Do not stop dual anti-platelet therapy after ACS or coronary stenting without discussion with the patient’s cardiologist.

Non steroidal anti-inflammatory drugs (NSAIDs) are included here for completeness. Their anti- platelet effect does not warrant withholding routinely before surgery but they may need to be withheld in patients at increased risk of post-operative renal dysfunction

Anti-platelet medications: Peak effects and timings for surgery

While they remain in the circulation these drugs will also affect transfused platelets. Therefore withhold on the day of surgery if platelet transfusion and/or major blood loss is a possibility.

Restarting anti-platelet medication after surgery

  • Anti-platelet medication may be restarted after surgery as soon as the bleeding risk is considered acceptable and the oral route is available.