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Preventive medication after stroke

If you have had a stroke or TIA that  was not caused by a bleed, it is  likely that you will be given medication to try to stop blood clots forming in your blood vessels. This is a preventive measure, which has been proven to be effective in reducing the risk of further strokes.

Antiplatelet medicines

Blood clotting happens when special cells called platelets stick together. Antiplatelet medicines make it more diffcult for \. There are 3 main antiplatelet medicines used in reducing the risk of stroke. These are aspirin, dipyridamole and clopidogrel. Antiplatelet medicines are often combined to make them more effective. However, this increases the risk of side effects, such as bleeding.

Anticoagulants

Warfarin is an oral anticoagulant that interferes with blood clotting, making the formation of clots more difficult. It is particularly useful in preventing strokes in people with atrial fibrillation and heart valve replacements.

Warfarin increases the risk of bleeding. Therefore it has to be taken with some caution and is not suitable for everybody. If you are prescribed warfarin, you will need regular blood tests. Your treatment will be monitored closely.

Some people have difficulty controlling their levels or keeping their levels stable or they are not able to take warfarin.

In these cases there is a different type of anticoagulant that your doctor may prescribe for you to prevent clots from forming in the blood. These are known as direct oral anticoagulants (DOACs)

DOACs currently in use are:

  • Dabigatran (Pradaxa®)
  • Rivaroxaban (Xarelto®)
  • Apixaban (Eliquis®)
  • Edoxaban (Lixiana®)

DOACs may be suitable for some people with atrial fibrillation. Your doctor will be able to discuss this with you.

For more information about anticoagulant medicines see the CHSS factsheet Warfarin (PDF)

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Other medical treatment

It is likely that your doctor will also recommend that you take additional medicines to reduce the
risk of further strokes.

Statins – medicines used to lower cholesterol.
Most people with an ischaemic stroke will be given statins even if their cholesterol is not high. If you are already taking a statin, you should continue to do so.

Antihypertensives – medicines used to control high blood pressure.
Antihypertensive treatment may also be recommended if you have had a stroke, even if your blood pressure is not raised.

Medicines can be provided in other forms if you have difficulty swallowing.

It is very important to take your medicines regularly, as prescribed by your doctor.