Anticoagulant And Antiplatelet Agents Used In Strokes

By Joe Flasher 

An important issue following an ischemic stroke is to find out why the stroke occurred and prevent another. Your doctor may recommend using medications to help reduce your risk of having another transient ischemic attack (TIA) or stroke. Drugs that decrease the likelihood of ischemic stroke include anticoagulants and anti-platelet agents.

Anti-platelet drugs make your cells less “sticky” and less likely to clot. Platelets are cells in the blood that initiate clots. The most frequently used anti-platelet medication is aspirin. Your doctor may recommend a dose from 81 mg. (baby aspirin) to 325 mg. Some aspirin are coated to not dissolve in the stomach but rather the small intestine and thereby, preventing the stomach problems seen with aspirin. Whether you use a brand name such as Bayer, Aspirin, or Ecotrin is a matter of personal preference. Your doctor may consider prescribing Aggrenox which is a combination of low-dose aspirin and Dipyridamole which is another anticoagulant to reduce blood clotting.

If aspirin doesn’t prevent TIA’s or you can’t take aspirin, you doctor may prescribe another anti-platelet drug such as Clopidogrel (Plavix) or Ticlopidine (Ticlid). There are other drugs used but these are the ones most commonly prescribed.

Anticoagulants affect the clotting system in a different manner than do anti-platelet medications. These drugs include Heparin and Warfarin (Coumadin). Heparin is a fast acting drug and is used over a short period of time in the hospital. Slower acting Warfarin is used over a longer time frame. These drugs have a profound affect on blood clotting and therefore require that you work with your doctor in monitoring their use.

There are many things to be aware of when taking anticoagulants. You must tell other doctors or dentists that you are taking anticoagulants. Never take aspirin unless your doctor tells you to. You must discuss with your doctor the medications you are taking before taking any other medicine such as vitamins, cold medicine, sleeping pills or antibiotics. Make sure your family knows how you take them and carry medical ID with you at all times.

If you take anticoagulants as they are prescribed for you, normally you will not have many problems but you should let your doctor know if any of the following occur:

    •     Your urine turns pink or red.

    •     Your stools turn red, dark brown or black.

    •     You bleed more than normal when you are menstruating.

    •     Your gums bleed frequently.

    •     You have a very bad headache or stomach pain that doesn’t go away.

    •     You get sick or you feel faint or dizzy.

    •     You often find unexplainable bruises or blood blisters on your body.


Once again, whether you take brand names of the above drugs or the generics it does not matter. However, you don’t want to be switching back and forth between brand and generics. Stay with whatever brand you start out with and your blood levels will be more regular and predictable. Take the brand that is most economical and agrees with your body.


Copyright © November 2003

The Stroke Network, Inc.

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