2. Duration of Therapy

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) – Monotherapy1-4,6-8
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
vorapaxar MI, stroke, thrombosis prophylaxis in patients with a history of MI or PAD indefinite, in combination with aspirin or clopidogrel

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 Duration1,2,9,10
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