What are the Common Medicines After an Ischemic Stroke

After a stroke, your health care provider may prescribe one or more types of medicine. Some of these medicines help to keep your blood from clotting, which may prevent future strokes. Other medicines may be used to help you manage health problems that can increase your risk of another stroke.

It is important to take all over-the-counter and prescription medicines only as told by your health care provider.

What are some commonly prescribed medicines after a stroke?

• Antiplatelet and anticoagulant medicines. They are also called blood thinners. Ischemic strokes are caused by blood clots that block an artery. These medicines help to keep your blood from clotting easily.
• Blood pressure medicines. High blood pressure can increase your risk of stroke. These medicines help to lower your blood pressure.
• Cholesterol medicines. Many strokes happen because blood vessels become clogged with plaque. This plaque buildup is caused by high levels of cholesterol in the blood. These medicines can help to lower cholesterol levels and lower your risk of another stroke.

What should I know about antiplatelet medicines?

• When a person starts to bleed, blood platelets release a chemical (thromboxane) that tells blood to clot. Antiplatelet medicines help to limit the amount of this chemical that is released. This makes it harder for your blood to clot, which can lower your risk of another stroke. The most common antiplatelet medicine is aspirin.
• These medicines may help reduce the negative effects of a stroke if they are taken shortly after the stroke happens. You may need to continue taking them on a long-term basis to help prevent a stroke in the future.
• You may need to take more than one antiplatelet medicine (dual antiplatelet therapy).
• People with certain health problems—such as gastrointestinal disease, bleeding disorders, or a history of kidney or liver disease—may not be able to take antiplatelet medicines.
• These medicines can increase the risk of bleeding because they work to keep blood from clotting. You may need to take certain precautions, such as:
  • Using a soft-bristle toothbrush.
  • Being careful when handling knives or razors.
  • Avoiding activities that could cause injury or bruising, and following instructions about how to prevent falls.
• Talk with your health care provider before you take any medicines that contain NSAIDs. These medicines increase your risk for dangerous bleeding.
• Take your medicine exactly as told, at the same time every day.

What should I know about anticoagulant medicines?

• Anticoagulant medicines keep the liver from making certain blood-clotting proteins. This makes it hard for your blood to clot, which can lower your risk of another stroke.
• These medicines are used to treat strokes that were caused by blood clots that formed in the heart. They are also used to treat people with an irregular heartbeat (atrial fibrillation) who have had a stroke.
• Certain anticoagulant medicines require regular blood tests to check that you are taking the right dosage.
• Some of these medicines can increase the risk of bleeding problems. When taking these medicines, you will need to take precautions such as:
  • Holding pressure over any cuts for longer than usual.
  • Avoiding contact sports or other activities that may cause trauma or injury.
  • Telling your dentist and other health care providers that you are taking anticoagulants before you have any procedures that may cause bleeding.
• These medicines can sometimes be affected by certain vitamins and foods. Talk with your health care provider about which foods, vitamins, and medicines you should avoid.
• Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs. These medicines increase your risk for dangerous bleeding.
• Take your medicine exactly as told, at the same time every day.

What should I know about cholesterol-lowering medicines?

• Some cholesterol medicines (statins) stop cholesterol from forming in the liver. This prevents bad cholesterol (LDL) from getting into the blood and clogging arteries. These medicines can also help to lower blood fats (triglycerides) and raise good cholesterol (HDL) levels.
• These medicines may cause muscle and liver problems. You may need regular blood tests to check the level of these medicines in your liver.
• There is a small risk that these medicines can increase your chance of developing type 2 diabetes.
• Grapefruit and pomegranate juices can affect how these medicines work. Talk with your health care provider about which foods, vitamins, and medicines you should avoid.

What should I know about blood pressure medicines?

• There are many different types of blood pressure medicines. You may need to take more than one type to lower your blood pressure.
• It can sometimes take time to find the right dosage of medicine.
• You will likely have to take blood pressure medicines for the rest of your life.
• Some over-the-counter medicines, such as cold and flu medicines, can affect blood pressure. Talk with your health care provider about which vitamins, supplements, and medicines you should avoid.

What questions should I ask my health care provider?

• How do these medicines work?
• What precautions should I take while on these medicines?
• Can I drink alcohol with these medicines?
• What are the risks of taking these medicines?
• What are some possible side effects of taking these medicines?
• What follow-up tests do I need?
• What else can I do to lower my risk of another stroke?

Get help right away if:

• You have any signs of unusual bleeding, such as bleeding from your gums, blood in your urine, bloody or dark stool, nosebleeds, or vomiting blood.
• You fall and hit your head while taking blood-thinning medicines.

Summary

• After a stroke, your health care provider may prescribe medicines that make it hard for your blood to clot, which can help to prevent future strokes.
• Your health care provider may instruct you to take other medicines to help manage health conditions that can increase your risk of another stroke.
• It is important to take all over-the-counter and prescription medicines only as told by your health care provider.
• Medicines that are commonly prescribed after a stroke include blood thinners, blood pressure medicines, and cholesterol medicines.
• Talk with your health care provider about what precautions you should take.