Understanding stroke

A stroke is a disruption in brain function caused by lack of blood flow to the brain.

A smaller stroke is called a ministroke, or transient ischemic attack (TIA). It happens when a blood clot only temporarily blocks blood flow to the brain.

The drugs used for treating stroke typically work in different ways.

Some stroke drugs actually break up existing blood clots. Others help prevent blood clots from forming in your blood vessels. Some work to adjust high blood pressure and cholesterol levels to help prevent blood flow blockages.

The drug that your doctor prescribes will depend on the kind of stroke you had and its cause. Stroke drugs can also be used to help prevent a second stroke in people who’ve already had one.

Anticoagulants are drugs that help keep your blood from clotting easily. They do this by interfering with the blood clotting process. Anticoagulants are used for preventing ischemic stroke (the most common type of stroke) and ministroke.

The anticoagulant warfarin (Coumadin, Jantoven) 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’ve had a heart attack or stroke.


Warfarin has also been linked to life-threatening, excessive bleeding. Tell your doctor if you have a bleeding disorder or have experienced excessive bleeding. Your doctor will most likely consider another drug.

Antiplatelets such as clopidogrel (Plavix) 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’re sometimes prescribed to people who’ve had ischemic strokes or heart attacks. Your doctor will probably have you take them on a regular basis for an extended period as a means of preventing secondary stroke or heart attack.

The antiplatelet aspirin is associated with a high risk of bleeding. Because of this, aspirin therapy isn’t always the best option for people who have no prior history of atherosclerotic cardiovascular disease (e.g., stroke and heart attack).

Aspirin should only be used for the primary prevention of atherosclerotic cardiovascular disease in people who:

  • are at high risk for a stroke, heart attack, or other types of atherosclerotic cardiovascular disease
  • are also at low risk for bleeding

Tissue plasminogen activator (tPA) is the only stroke drug that actually breaks up a blood clot. It’s used as a common emergency treatment during a stroke.

For this treatment, tPA is injected into a vein 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.

Statins 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.

These drugs block HMG-CoA reductase, an enzyme that your body needs to make cholesterol. As a result, your body makes less of it. This helps reduce the risk of plaque and prevent ministrokes and heart attacks caused by clogged arteries.

Statins sold in the United States include:

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:

Several different types of drugs can help treat or prevent stroke. Some help prevent blood clots by directly interfering with the way that clots form. Some treat other conditions that can lead to stroke. tPA helps dissolve clots after they’ve already formed in your blood vessels.

If you’re at risk for stroke, talk to your doctor. It’s likely that one of these drugs may be an option to help you manage that risk.