Transient Ischemic Attack (TIA) - Medications

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 aspirin, aspirin with extended-release dipyridamole, or clopidogrel) keep platelets in the blood from sticking together.

• Aspirin is most often used to prevent TIAs and strokes. Many studies have shown that aspirin 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 aspirin or for whom aspirin has not been effective.
• Aggrenox, a medicine that combines aspirin with dipyridamole, is a safe and effective alternative to aspirin 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.