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Cardiovascular system disorders, Guidance

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Using clopidogrel with proton pump inhibitors (PPIs)

22 May 2023Avoid the combined use of clopidogrel with omeprazole or esomeprazole due to a significant interaction. Other PPIs are considered safe with clopidogrel.

Using angiotensin-II receptor antagonists during breastfeeding

11 May 2023Very limited data suggest breastmilk levels are likely to be low, but other medicine classes are preferred. Recommendations apply to full term, healthy infants.

Using lipid-lowering medicines during breastfeeding

21 April 2023Rosuvastatin, pravastatin and atorvastatin are preferred; simvastatin and ezetimibe can also be used. Recommendations apply to full term and healthy infants.

Identifying risk factors for developing a long QT interval

29 March 2023Some medicines (erythromycin, citalopram, ondansetron) can cause a long QT interval. Consider risk factors and follow MHRA recommendations for safe use.

Using ACE inhibitors during breastfeeding

28 March 2023Enalapril is the angiotensin converting enzyme (ACE) inhibitor of choice during breastfeeding. Recommendations apply to full term and healthy infants only.

Using amlodipine or MR felodipine for angina and hypertension

13 March 2023Guidance on choosing and switching between amlodipine and modified-release (MR) felodipine for angina and hypertension.

Managing peripheral oedema caused by calcium channel blockers

26 September 2022All calcium channel blockers may cause peripheral oedema. There are different treatment options and the incidence can be affected by different factors.

Using coenzyme Q10 supplements for statin-induced muscle symptoms

18 February 2022People often buy coenzyme Q10 supplements to help with statin-induced muscle symptoms. However, there is insufficient evidence to recommend its use.

Hypertension: treatment during pregnancy

6 January 2022Signposting evidence-based information on the treatment of hypertension in pregnancy

Choosing an antidepressant for people with coronary heart disease

2 July 2021Making a suitable choice of antidepressant in CHD needs to include considerations of both the patient and the characteristics of the medicines.