Key takeaways:
The most common type of stroke happens when a blood clot blocks blood flow in your brain. Two common stroke medications are antiplatelets and anticoagulants (blood thinners).
Antiplatelets, such as aspirin, are helpful if your stroke was caused by platelets (blood cell pieces). Anticoagulants, such as apixaban (Eliquis), are typically prescribed if atrial fibrillation (an abnormal heart rhythm) caused your stroke.
Other health conditions, such as high blood pressure, can raise your risk of having a stroke. If you have a stroke, your prescriber may suggest medication changes to manage these conditions.
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A stroke happens when blood doesn’t flow correctly in your brain. This prevents oxygen and nutrients from reaching your brain cells. A stroke can be life-threatening and cause permanent brain damage and disability.
After having a stroke, you will likely be prescribed one or more medications. These help aid in recovery and aim to prevent a future stroke. Depending on your health history, your prescriber may recommend more medications to further reduce your stroke risk.
Which stroke medications can you expect to be prescribed?
Good to know: This article will review medications that are prescribed after an ischemic stroke (when a blood clot gets stuck in a brain blood vessel). This is the most common type of stroke. Treatments used to manage a hemorrhagic stroke (when a brain blood vessel bursts) are different from what’s discussed here.
Commonly prescribed medications for stroke recovery
Several stroke medications are recommended by the American Stroke Association and American Heart Association. Your healthcare team will take your health history and risk factors into account when determining which ones are right for you.
While in the hospital, you will ideally receive treatments or undergo procedures to help break up the clot causing your stroke. After that, you’ll be prescribed medications that help prevent another stroke.
The main types of medications prescribed after a stroke are antiplatelets and anticoagulants (blood thinners). It’s not usually recommended for people to take both of these medications. Combining them raises the risk of serious bleeding. Your prescriber will determine whether an antiplatelet or anticoagulant is better for your situation.
Antiplatelets
Platelets are pieces of blood cells that form clots to help stop unwanted bleeding, such as cuts. But if clots form and get stuck in your brain blood vessels, then a stroke can happen.
Antiplatelet medications help prevent platelets from sticking together and making clots. Several antiplatelet medications are available. Depending on your health history, you could be prescribed one or more antiplatelets.
Antiplatelets that are prescribed after a stroke include:
Clopidogrel (Plavix)
Ticagrelor (Brilinta)
Anticoagulants
Anticoagulants are commonly called blood thinners. These medications can also help prevent clots from forming — but in a different way. Instead of targeting platelets, anticoagulants stop red blood cells from sticking together.
If you have an abnormal heart rhythm, called atrial fibrillation (AFib), blood can get stuck in the heart. After some time, those blood cells can start to stick together and form a blood clot. If this clot gets pumped out of the heart, it can travel and get stuck in brain blood vessels. This can cause a stroke.
Anticoagulants can help prevent these types of clots from forming. If your stroke was caused by AFib, you’ll likely be prescribed an anticoagulant medication.
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Some commonly prescribed anticoagulant medications include:
Warfarin (Coumadin, Jantoven)
Dabigatran (Pradaxa)
Apixaban (Eliquis)
Rivaroxaban (Xarelto)
Edoxaban (Savaysa)
Are there other poststroke medications you may need?
You may need other medications depending on what other health conditions you have. If you have a condition that raises your risk of a stroke, you may also be prescribed medications to help treat it. Below are details on medications used to manage common conditions that can lead to a stroke.
High blood pressure medications
Hypertension (high blood pressure) can raise your risk of having a stroke. If your blood pressure is high, you could be prescribed one or more blood pressure medications after a stroke. If you’re already taking blood pressure medications, your prescriber may adjust your medications or dosages.
Blood pressure medications that may be prescribed after a stroke include:
Thiazide diuretics (water pills), such as hydrochlorothiazide (Microzide)
Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril, Qbrelis)
Angiotensin II receptor blockers (ARBs), such as losartan (Cozaar)
High cholesterol medications
Another condition you’ll be checked for after a stroke is high cholesterol. When cholesterol is too high, it raises your risk of a stroke. Healthcare professionals often keep a close eye on one type of cholesterol: low-density lipoprotein (LDL, or “bad” cholesterol). Your prescriber can tell you the ideal LDL range for you.
Cholesterol medications that may be prescribed after a stroke include:
High-intensity statins, such as higher-dose atorvastatin (Lipitor, Atorvaliq)
Ezetimibe (Zetia)
PCSK9 inhibitors, such as evolocumab (Repatha)
Bempedoic acid (Nexletol)
Diabetes medications
Having diabetes can raise your risk of a stroke. Regulating your blood glucose (blood sugar) levels can help lower this risk. In some cases, your prescriber may make adjustments to your diabetes treatment regimen if you have had a stroke. This will depend on how well your current medications and lifestyle changes are working.
There are many types of diabetes medications, including oral and injectable options. Your prescriber can help determine which options would be right for you. Commonly prescribed diabetes medications include:
Glucagon-like peptide 1 (GLP-1) receptor agonists, such as semaglutide (Ozempic, Rybelsus)
Sodium-glucose cotransporter-2 (SGLT2) inhibitors, such as empagliflozin (Jardiance)
How long do you have to take medicine after a stroke
This depends on many factors, including which stroke medication you’re taking.
If you’re taking antiplatelets, it’s common to take two medications in this class for about 1 month after having a stroke. Some people may need to take two antiplatelets for up to 3 months. After this initial period, your prescriber will likely recommend taking one antiplatelet. Low-dose aspirin is a common choice. You’ll typically take this medication long term to help prevent future strokes.
If you’re taking an anticoagulant, you’ll likely need to take it long term. Healthcare professionals typically prescribe anticoagulants only for strokes caused by AFib. Since AFib is a chronic health condition, you’ll likely need lifelong treatment to help lower your risk for future strokes.
Frequently asked questions
There is no single “best” stroke medication for everyone. The medication you take depends on the cause of your stroke. It’s common to take one or more antiplatelets, such as aspirin and ticagrelor. But if AFib caused your stroke, you’ll likely take an anticoagulant, such as apixaban.
Thrombolytics (“clot busters”), such as tenecteplase (TNKase), can help dissolve clots that are causing a stroke. These medications are administered in a hospital setting. But there’s a short window of time when you can receive these medications. So it’s important to seek emergency medical help quickly if you’re having stroke symptoms.
Clot busters, such as tenecteplase, are sometimes referred to as “miracle drugs” for people having a stroke. If provided soon enough, these medications can restore blood flow to the brain. They can also raise your chances of fully recovering after having a stroke.
There is no single “best” stroke medication for everyone. The medication you take depends on the cause of your stroke. It’s common to take one or more antiplatelets, such as aspirin and ticagrelor. But if AFib caused your stroke, you’ll likely take an anticoagulant, such as apixaban.
Thrombolytics (“clot busters”), such as tenecteplase (TNKase), can help dissolve clots that are causing a stroke. These medications are administered in a hospital setting. But there’s a short window of time when you can receive these medications. So it’s important to seek emergency medical help quickly if you’re having stroke symptoms.
Clot busters, such as tenecteplase, are sometimes referred to as “miracle drugs” for people having a stroke. If provided soon enough, these medications can restore blood flow to the brain. They can also raise your chances of fully recovering after having a stroke.
The bottom line
Antiplatelets and anticoagulants (blood thinners) are the two main medications prescribed after you’ve had a stroke. Antiplatelets, such as aspirin, are a common choice. Anticoagulants, such as apixaban (Eliquis), can be helpful if your stroke was caused by atrial fibrillation.
If you have other health conditions, such as high blood pressure, your prescriber may recommend additional medications after a stroke. These treatments help manage other conditions that can cause a stroke.
Most people take at least one stroke medication long term. This helps lower your risk of future strokes.
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References
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