An ischemic stroke, commonly referred to simply as stroke, is a disruption in brain function caused by lack of blood flow to the brain. Four different factors can contribute to a stroke, but all of them lead to a blockage of blood flow that cuts off the oxygen supply to your brain. A smaller stroke is called a transient ischemic attack (TIA). It happens when a blood clot only temporarily blocks the blood flow.
The drugs used for treating stroke typically work in different ways. Some actually break up existing blood clots. Others help prevent blood clots from forming in your blood vessels. Some drugs work to adjust high blood pressure and cholesterol levels to help prevent blood flow blockages. The drug that your doctor prescribes depends on the kind of stroke you had and its cause. These drugs can also be used to help prevent a second stroke in people who have already had one.
Anticoagulants are drugs that help keep your blood from clotting easily by interfering with the blood clotting process. These are used for preventing ischemic strokes and TIAs.
Warfarin (Coumadin, Jantoven, Marfarin) is used to prevent blood clots from forming or to prevent existing clots from getting larger. It’s often prescribed to people with artificial heart valves or irregular heartbeats or people who have had a heart attack or stroke.
Antiplatelets such as clopidogrel (Plavix) and aspirin can be used to help prevent blood clots. They work by making it more difficult for the platelets in your blood to stick together, which is the first step in the formation of blood clots. They are sometimes prescribed to people who have had ischemic strokes or heart attacks. Your doctor will probably have you take them on a regular basis for an extended period for prevention of heart attack and stroke.
Tissue plasminogen activator (TPA) is the only stroke drug that actually breaks up a blood clot. It is used as a common emergency treatment during a stroke. For this treatment, TPA is injected into a vein or artery so it can get to the blood clot quickly. TPA isn’t used for everyone. People at high risk of bleeding into their brain aren’t given TPA.
Statin drugs help lower high cholesterol levels. When your cholesterol levels are too high, cholesterol can start to build up along the walls of your arteries. This buildup is called plaque. The drugs block an enzyme in your body that is needed to make cholesterol, so your body makes less of it. This helps reduce the risk of plaque and prevent TIAs and heart attacks caused by clogged arteries.
Statins sold in the United States include:
- atorvastatin (Lipitor, Torvast)
- fluvastatin (Lescol)
- lovastatin (Altocor, Altoprev, Mevacor)
- pitavastatin (Livalo)
- pravastatin (Pravachol)
- rosuvastatin (Crestor)
- simvastatin (Zocor)
Your doctor may also prescribe medications to help lower your blood pressure. High blood pressure can play a major role in stroke. It can contribute to chunks of plaque breaking off, which can lead to the formation of a blood clot. Blood pressure drugs used for this type of treatment include:
- angiotensin-converting enzyme (ACE) inhibitors
- calcium channel blockers
Several different types of drugs can help treat or prevent stroke. Some directly interfere with the way blood clots form to help prevent them. Some treat other conditions that can lead to stroke. One drug helps dissolve clots after they have already formed in your blood vessels.
If you’re at risk of stroke, talk to your doctor. It is likely that one of these drugs may be an option to help you manage that risk.