AKT-0469

AKT-0469

You are conducting a medication review for a 65-year-old man who has a history of cerebrovascular disease (having suffered a stroke 2 years ago), depression, and knee osteoarthritis. He is currently taking the following medications:
– Clopidogrel 75 mg once daily
– Simvastatin 20 mg once daily
– Amlodipine 5mg once daily
– Ramipril 10 mg once daily
– Diclofenac 50 mg as needed
– Sertraline 50 mg once daily

What changes would you recommend to his medication regimen?