2. Duration of Therapy

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There is no basis for limiting PAI therapy duration when prescribed to prevent thromboembolic events associated with cardiovascular or cerebrovascular disease. However, PAI therapy duration varies based on medication utilized and indication for use. PAI treatment durations are summarized in Tables 3 and 4.

Table 3. PAI Recommended Treatment Duration (Adults) – Monotherapy [1-4,6,7]
Drug Name	Treatment Indication	Maximum Treatment Duration
cilostazol	intermittent claudication	indefinite
clopidogrel	acute coronary syndrome (NSTE-ACS and STEMI)	up to 1 year, in combination with aspirin; aspirin then continued indefinitely +
	thromboembolism prophylaxis	indefinite
prasugrel	ACS in patients to be managed with PCI	at least 12 months, in combination with aspirin, after stent placement
ticagrelor	ACS	90 mg twice daily x 1 year in combination with aspirin; then, 60 mg twice daily in combination with aspirin indefinitely

Legend:

ACS = acute coronary syndrome
CAD = coronary artery disease
MI = myocardial infarction
NSTE-ACS = non-ST-elevation acute coronary syndrome
NSTEMI = non-ST-elevation myocardial infarction
PAD = peripheral arterial disease
PCI = percutaneous coronary intervention
STEMI = ST-elevation myocardial infarction
TIA = transient ischemic attack
+ in patients with aspirin allergy, clopidogrel monotherapy may be continued indefinitely

Table 4. Adult PAI Recommended Combination Therapy Treatment Duration [1,2,8]
Drug Name	Treatment Indication	Maximum Treatment Duration
aspirin/omeprazole	secondary prevention of cardiovascular and cerebrovascular events in patients predisposed to gastric ulcers	indefinite
dipyridamole/aspirin	stroke prevention	indefinite