Antiplatelet Medications That Can Prevent a Stroke

In the U.S., someone has a stroke every 40 seconds. That’s about 800,000 people per year. These statistics can be scary, especially since a stroke can be a life-threatening condition.

The good news is that most strokes are preventable. Lifestyle changes, medications, or a combination of both can lower your risk. Antiplatelet medications are recommended for people with certain risk factors.

Let’s review antiplatelet medications and see how they’re used.

How do antiplatelet medications work to prevent a stroke?

Platelets are a type of blood cell. Their main job is to stop bleeding by clumping together to form blood clots. Blood clots are a normal part of your body’s healing process.

But clots can cause serious problems if they happen in the wrong place. If a blood clot forms in a brain blood vessel, it can cause a stroke. 

A stroke is when part of the brain doesn’t get enough blood. The lack of blood can be due to a blockage (an ischemic stroke) or a burst blood vessel (a hemorrhagic stroke). Both can permanently injure the brain. Most strokes are ischemic.

Antiplatelet medications prevent your platelets from clumping together. They can help prevent ischemic strokes. These medications can also treat or prevent heart attacks, and they can prevent complications from peripheral artery disease (PAD).

Read more like this

Explore these related articles, suggested for readers like you.

How Long Will I Need to Take Plavix (Clopidogrel) After a Heart Attack?

Keeping A Self-Proclaimed “Medical Weirdo” And Her Doctor Happy

Should I Take Aspirin If I Have High Blood Pressure?

What You Need to Know About Aggrenox

View more

Antiplatelet vs. anticoagulant: What’s the difference?

Antiplatelet medications and anticoagulants are antithrombotic medications — also called blood thinners. They help treat and prevent blood clots. But they work in different ways. 

Your body uses two methods to form blood clots and prevent bleeding. One method involves platelets sticking together, as discussed above. Antiplatelet medications prevent platelets from clumping together to form clots.

The other method involves clotting factors — proteins made by the liver. Some anticoagulants like warfarin (Coumadin, Jantoven) prevent your body from making clotting factors. Others, like apixaban (Eliquis), prevent clotting factors from working properly. 

Most strokes happen when platelets, fats, and other substances clump together in a brain blood vessel. Antiplatelets can help prevent these strokes.

But some strokes happen when blood clots formed somewhere else in the body get lodged in the brain. This is called a cerebral embolism and is often caused by an abnormal heartbeat. In those cases, an anticoagulant is more appropriate. 

How do you take antiplatelet medications?

Most antiplatelet medications are taken once or twice daily by mouth. Some are injectable, but they’re not used for stroke prevention. Those are only given in the hospital by a healthcare provider. 

Here’s some basic information about a few common antiplatelet medications:

• Aspirin: Take your recommended dose (usually between 81 mg and 325 mg) by mouth once daily with or without food. A chewable tablet is available if you can’t swallow pills.

• Clopidogrel (Plavix): Take 75 mg by mouth once daily with or without food. If needed, you can crush the tablet.

• Aspirin/dipyridamole (Aggrenox): Take 1 capsule by mouth 2 times a day with or without food. Don’t crush or chew it. If you can’t swallow the capsule whole, ask your provider about alternatives.

• Ticagrelor (Brilinta): Take your recommended dose (60 mg to 90 mg) by mouth 2 times a day with or without food. If needed, you can crush the tablet.

How effective are different antiplatelet medications?

If you’ve had a stroke, taking aspirin lowers your risk of future strokes by 17%. You may be instructed to take aspirin with or without other antiplatelets.

Aspirin isn’t as helpful if you’ve never had a stroke before. In this situation, it’s recommended that only certain people with a high risk of stroke take aspirin. Don’t take aspirin daily to prevent a first-time stroke unless your provider recommends it.

Aspirin/dipyridamole and clopidogrel are only FDA approved for preventing repeat strokes. Ticagrelor is approved to prevent both first-time and repeat strokes. But it should only be used for preventing first-time strokes when someone has heart disease.

Compared to taking aspirin by itself, research suggests that aspirin/dipyridamole is better at preventing repeat strokes. Studies show that clopidogrel and ticagrelor are similarly effective as aspirin.

Combining aspirin and ticagrelor is more effective than aspirin alone right after you’ve had a stroke. But doing this also raises your risk of bleeding. So experts recommend only certain people with higher risks take this combination temporarily.

Similarly, some people with higher risks may take clopidogrel and aspirin together for up to 3 months.

Clopidogrel may not work well for some people because of genetic differences. These people’s bodies can’t break down the medication and use it. People of East Asian descent are more at risk for this problem. Speak to your healthcare provider if this is a concern for you.

There are other ways to lower your risk of a stroke even further. These include:

• Controlling any high blood pressure

• Controlling diabetes if you have it

• Quitting smoking

• Eating a heart-healthy diet

• Being more active

• Lowering cholesterol

• Losing weight or treating obesity

Healthy lifestyle changes are as important as medications in preventing repeat strokes. Plus, they lower your risk of heart disease and heart attacks.

What are the biggest side effects of taking antiplatelet medications?

The biggest side effects with antiplatelet medications are linked to bleeding risks.

Bleeding

Antiplatelet medications raise your risk of bleeding. This is an expected side effect with all blood thinners. Anything that prevents clots also makes you more likely to bleed.

Antiplatelet medications are responsible for many hospital admissions. This is especially true when you take them long term. However, the risk of serious bleeding is low. In studies, ticagrelor, clopidogrel, and aspirin/dipyridamole caused serious bleeding in fewer than 5% of participants. 

With antiplatelet medications, it’s normal to bleed more when you get cut. Call your healthcare provider right away if you experience bloody or dark-colored stools when you go to the bathroom. These could be signs of internal bleeding.

Your risk of bleeding is higher if you take other blood-thinning medications. Make sure your healthcare provider knows all the medications that you take, including over-the-counter (OTC) medications and supplements.

Stomach upset or damage from aspirin

Aspirin can irritate the stomach. In rare instances, it can cause serious damage to the stomach or intestines. This is one reason why a daily aspirin isn’t right for everyone.

Taking aspirin with food or milk may ease an upset stomach. Switching to an enteric-coated (EC) version may also help. However, EC aspirin may be less effective. It’s best to discuss this version with your healthcare provider before switching.

Other side effects to know about

The most common side effect from aspirin/dipyridamole is headaches. For most, this side effect goes away within 1 week. Talk to your healthcare provider if the headache is too bothersome for you. They may recommend you change how you’re taking the medication for a short period of time.

The most common side effect from ticagrelor is trouble breathing. This temporary side effect should let up within 1 week. Talk to your healthcare provider if it’s excessive or doesn’t get better. If you experience trouble breathing along with chest pain, dizziness, or nausea, call 911. These are potential signs of a heart attack.

How much do antiplatelet medications cost?

Knowing the cost of your medication is important. GoodRx can help you save on your antiplatelet.

Brilinta offers additional savings on their website. If eligible, their copay card could bring the price down to $5 a month. Click or tap here to see if you qualify.

Aspirin is available OTC. To take advantage of any GoodRx savings, ask your healthcare provider to write a prescription for it.

How does your healthcare provider pick the right antiplatelet medication for you?

Aspirin is often used to treat or prevent strokes. It’s well-studied, effective for preventing many kinds of strokes, and affordable. Aspirin is recommended for many people to prevent repeat strokes. It’s also recommended for preventing first-time strokes in certain people with higher risk.

For most who’ve had a stroke, experts recommend long-term aspirin, clopidogrel, or aspirin/dipyridamole. They’re all similarly effective. When deciding which to prescribe, your healthcare provider will consider your other medical conditions, medications, and test results.

Why trust our experts?

Written by:

Aileen Chu, PharmD, BCPS

Aileen Chu, PharmD, has over 8 years of experience working as a clinical pharmacist in the emergency department, where she sees the consequences of people not being empowered to take their medications correctly. This experience has made her especially passionate about helping patients understand their medications and ensuring that medications are affordable and accessible.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Our editorial standards

Meet our experts