Medications
Your doctor will probably prescribe several medicines after you
have had a
transient ischemic attack (TIA). Medicines to prevent
blood clots are typically used, because blood clots can cause TIAs and
strokes.
The types of medicines that prevent clotting are:
- Antiplatelet
medicines.
- Anticoagulant medicines.
Cholesterol-lowering and blood pressure-lowering medicines are also
used to prevent TIAs and strokes.
Antiplatelet medicines
Antiplatelets (such as ASA, ASA with extended-release
dipyridamole, or clopidogrel) keep
platelets in the blood from sticking together.
- ASA is most often used to prevent TIAs and
strokes. Many studies have shown that ASA helps prevent strokes and reduces the
risk of another TIA in people who have had their first TIA.
- Other
antiplatelet medicines (such as clopidogrel) may be used for people who cannot
take ASA or for whom ASA has not been effective.
- Aggrenox, a
medicine that combines ASA with dipyridamole, is a safe and effective
alternative to ASA to prevent TIA and stroke for some people.8 However, people with chronic stable
angina cannot take dipyridamole.
Anticoagulants
Anticoagulants prevent the production of certain proteins that
are needed for blood to clot. If you have
atrial fibrillation, you will probably take an
anticoagulant (such as warfarin). Anticoagulants are
more effective than antiplatelets in preventing strokes in people with atrial
fibrillation.4
Both anticoagulants and antiplatelets increase the risk of
bleeding. Warfarin (such as Coumadin) has the highest risk of bleeding
problems, but the risk is lower when the dosage is closely monitored.
If you take warfarin, don't suddenly change your intake of foods
that are rich in vitamin K. Vitamin K can interfere with the action of
anticoagulants, making it more likely that your blood will clot. For more
information, see:
Eating a steady amount of vitamin K when you
take warfarin (Coumadin).
Cholesterol-lowering medicines
Experts recommend that most people who have had a TIA take
statins, which lower cholesterol. Many studies show
that statins significantly reduce the risk of stroke in people who have had a
TIA. Statins even protect against stroke in people who do not have heart
disease or high cholesterol.5 For more information on
these medicines, see the topic
High Cholesterol.