Stroke treatment: Medicines

Not all stroke medicines are right for all stroke survivors.

Your doctor will decide which medicines are right for you. He or she will based this decision on your risk factors, medical history and medicine allergies.

The following are some medicines you may take.

Anti-platelets

Platelets circulate (move) in your blood and add to the formation of blood clots.

Anti-platelet medicines like aspirin, clopidogrel, extended release dipyridamole and aspirin in combination, and ticlopidine help prevent stroke because they keep the blood from clotting.

Aspirin

Because of its safety and low cost, aspirin is often the first choice for stroke prevention.

• If aspirin upsets your stomach you may take a coated aspirin.
• One aspirin a day is often a good dose.
• Over-the-counter medicines like Tylenol®, Advill® or Alevel® do not keep the blood from clotting. Only aspirin has this benefit.

Extended release dipyridamole and aspirin combination (Aggrenoxl®), clopidogrel (Plavixl®), ticlopidine (Ticlidl®) and others

Like aspirin, these medicines keep your blood from clotting. They are available only prescription.

• dipyridamole and aspirin combination (Aggrenoxl®)
• clopidogrel (Plavixl®)
• ticlopidine (Ticlidl®)

Your doctor will decide if any of these medicines will work better for you than aspirin.

Anti-coagulants

Anti-coagulant medicines keep you from getting blood clots. You may hear people call these medicines "blood thinners."

Warfarin (Coumadinl®) is often used in patients who have heart problems or artificial heart valves. To see how well warfarin is working, you will have a blood test call the international normalized ratio (INR). This helps decide the best dose of medicine for you.

Tissue plasminogen activator (t-PA)

Tissue plasminogen activator (t-PA or thrombolytic therapy) dissolves blood clots, but it may cause bleeding (including bleeding into the brain).

• This medicine must be given within 3 hours of the start of stroke symptoms.
• You will not be given t-PA if your blood pressure is too high, if changes on a CT scan show it should not be given, or if the risk of bleeding is too great.

Heparin / heparinoid medicines

Heparin medicines slow the creating of blood clots. But there is little, if any, benefit in treating stroke. The medicines also can cause bleeding.