Medication to prevent another stroke

Most people who have had a stroke are prescribed medication to reduce their risk of having another one. People who have recurrent Transient Ischaemic Attacks are also prescribed medication to reduce their risk of a stroke. 

  • medication to reduce blockages in arteries from blood clots - antiplatelets or anticoagulants
  • medication to lower blood pressure - antihypertensives and
  • medication to lower cholesterol levels - statins.

The type of medication taken will depend on the type of stroke (bleed or clot) and factors that might have contributed to causing it (e.g. have high blood pressure or high cholesterol). 

A few people were not keen on the idea of taking medication, particularly if they had previously not had to take any. However, most people also said that they took the medication because it was important to avoid having another stroke. One person described their medication as 'a life saver'. 

Taking medicines regularly
People realised the importance of taking their medication regularly. Whilst some said they found it easy to remember what medication they had to take and when, others needed a little help. One woman explained that whilst she had been in hospital they had been given more and more responsibility for remembering their medication which she found very helpful. She still found it difficult to remember and now writes down when she has taken her tablets and uses an alarm as a reminder. 

Several people had a special pill box with days of the week and times labelled, which they or a relative would fill at the beginning of each week. A few, older people, those who lived alone or those who had a specific problem with remembering to take their medication had their tablets provided in special blister packs marked with days of the week and times.

A man explained that he uses a special pill box and is generally very good at remembering his medication but he forgot once and knew to discard those pills and start the next day fresh.

Treatment for high blood pressure (antihypertensives)
High blood pressure can lead to an increase risk of having a stroke. High blood pressure is linked to both strokes caused by a bleed (haemorrhage) or a clot. Many people we spoke to had been found to have high blood pressure and were prescribed medication to control it and to help prevent another stroke. However, a few, often younger people, had strokes which were not caused by high blood pressure.

There are several different types of medication which work slightly differently to control blood pressure (antihypertensives) including: ACE inhibitors,calcium channel-blockers, beta- blockers and thiazide diuretics (see information from Chest heart and Stroke Scotland: Living with High Blood Pressure). Some people were taking more than one type of medication to control their blood pressure. It was sometimes necessary for the doctor to try a number of different medications before they found the one that was most suitable or to change the medication if there was a change in blood pressure. 

Most people said they had no side effects from the blood pressure medication. A few people who were taking a water tablet as part of their medication to control blood pressure said they needed the toilet more often. A couple of people felt that the blood pressure medication made them less responsive, one man worried that his driving would be affected so changed to taking his medication before a sleep in the afternoon. 

Medication to prevent clots forming (antiplatelets or anticoagulants)
Those people whose stroke had been caused by a blood clot were prescribed medication which stop the platelets in the blood sticking together (antiplatelet drugs). The most commonly prescribed drug was aspirin. A few people were being prescribed aspirin plus another anti-clotting drug dipyridamole or clopidogrel, which together are more effective at preventing clots than either alone. One woman explained that she now takes a tablet that contains both aspirin and dipyridamole which she finds much easier to take although sometimes it is not available in the hospital.

Aspirin can sometimes cause problems with the stomach and a few people had been prescribed a drug to take that protects the stomach lining, such as lansoprazole. If the symptoms are very severe an alternative to aspirin called clopidrogrel can be prescribed. 

People whose stroke had been caused by a clot from an irregular heartbeat (atrial fibrillation), a problem with a heart valve or sometimes a block to the carotid artery were prescribed the anticoagulant warfarin. Warfarin needs to be carefully monitored which means having regular blood tests. Often people have to take different amounts of warfarin, usually tablets of different colours, on different days. One man said he found this difficult.

It is important when you are on warfarin that you eat regular meals and avoid too much alcohol. People had also been warned not to have too many foods which contain vitamin K because they interfere with the warfarin (spinach, brussel sprouts, cabbage, watercress, broccoli). One woman explained that she could eat these vegetables but not every day.

Although many found they experienced no side effects of anti-clotting drugs some said that they had noticed that they bruised much more easily.  People who took warfarin could sometimes have problems stopping bleeding from cuts.

People taking warfarin need regular blood tests to check that the dose is right, but there are newer drugs to reduce blood clots such as dabigatran, apixaban and rivaroxaban which do not need any blood tests and they may be used more often in the future.

See the Stroke Association leaflet ‘Blood thinning medication after stroke’ for more information on blood thinning medication.

Medication to reduce cholesterol
High cholesterol is a risk factor for stroke and many people had been prescribed a statin drug to help reduce their cholesterol following their stroke there are several available such as atorvastatin, simvastatin and rosuvastatin. There is evidence to suggest that statins are beneficial in preventing a further stroke irrespective of the person's cholesterol level. A young woman explained that she had been put on a statin as a precaution even though her cholesterol level was okay. 

Several people explained that they needed to take their statin at night as this was when the cholesterol was formed.

Most people said that they did not have any side effects from the statins. One woman had experienced some hair loss and had changed to a different statin. A man had some itchiness which he thought might be due to the statin and a woman felt she had put on weight since being on the statin. 

Last reviewed June 2017.
Last updated
June 2017.



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