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Anticoagulant Use (Aspirin, Clopidogrel, Warfarin)

Sheldon H. Gottlieb, M.D., Paul A. Pham, Pharm.D.
Anticoagulant Use (Aspirin, Clopidogrel, Warfarin) is a topic covered in the Johns Hopkins Diabetes Guide.

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  • Aspirin: secondary prevention: treatment of transient transchemic attack (TIA) and ischemic stroke; prevent recurrent myocardial infarction (MI); reduce risk of MI or sudden death in unstable angina and chronic stable angina; after angioplasty, coronary artery bypass graft (CABG), carotid endarterectomy.
  • Clopidogrel (Plavix): secondary prevention: acute coronary syndromes (unstable angina, non-ST elevation MI including those who are to be managed with coronary revascularization, ST elevation MI, after MI, stroke, established peripheral vascular disease.
  • Warfarin: secondary indication: prophylaxis or treatment of thromboembolism in atrial fibrillation, mechanical heart valves; reduce risk of stroke or recurrent MI after MI; prophylaxis or treatment of venous thrombosis or thromboembolism in high-risk patients.
  • Dabigatran (Pradaxa): primary and secondary prevention of stroke in non-valvular atrial fibrillation. FDA warning: do not use in patients with mechanical heart valves.
  • Rivaroxaban (Xarelto): primary and secondary prevention of sroke in non-valvular atrial fibrillation; prevention of deep vein thrombosis (DVT) after hip and knee surgery; secondary prevention after DVT and pulmonary embolism.
  • Apixaban (Eliquis): primary and secondary prevention of stroke in non-valvular atrial fibrillation.


  • Aspirin: primary prevention of cardiovascular events in diabetes (see Routine Preventive Care).
  • Clopidogrel (Plavix): primary prevention not established.
  • Warfarin: primary prevention not established.
  • Pradaxa, Rivaroxaban, Apixaban: primary prevention not established. Note FDA warnings re: mechanical heart valves.

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Last updated: September 27, 2013


Gottlieb, Sheldon H, and Paul A Pham. "Anticoagulant Use (Aspirin, Clopidogrel, Warfarin)." Johns Hopkins Diabetes Guide, 2013. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547009/all/Anticoagulant_Use__Aspirin_Clopidogrel_Warfarin_.
Gottlieb SH, Pham PA. Anticoagulant Use (Aspirin, Clopidogrel, Warfarin). Johns Hopkins Diabetes Guide. 2013. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547009/all/Anticoagulant_Use__Aspirin_Clopidogrel_Warfarin_. Accessed July 20, 2019.
Gottlieb, S. H., & Pham, P. A. (2013). Anticoagulant Use (Aspirin, Clopidogrel, Warfarin). In Johns Hopkins Diabetes Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547009/all/Anticoagulant_Use__Aspirin_Clopidogrel_Warfarin_
Gottlieb SH, Pham PA. Anticoagulant Use (Aspirin, Clopidogrel, Warfarin) [Internet]. In: Johns Hopkins Diabetes Guide. ; 2013. [cited 2019 July 20]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547009/all/Anticoagulant_Use__Aspirin_Clopidogrel_Warfarin_.
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TY - ELEC T1 - Anticoagulant Use (Aspirin, Clopidogrel, Warfarin) ID - 547009 A1 - Gottlieb,Sheldon,M.D. AU - Pham,Paul,Pharm.D. Y1 - 2013/09/27/ BT - Johns Hopkins Diabetes Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547009/all/Anticoagulant_Use__Aspirin_Clopidogrel_Warfarin_ DB - Johns Hopkins Guide DP - Unbound Medicine ER -