brain, spinal cord, and nerve disorders
Transient Ischemic Attacks (TIAs)
Medications
People may be given a medication to make blood less likely to clot (an antiplatelet medication or an anticoagulant). Taking an antiplatelet medication, such asaspirin, a combination tablet of low-doseaspirinplusdipyridamole,clopidogrel, orclopidogrelplusaspirin, reduces the chance that clots will form and cause TIAs or ischemic strokes. Antiplatelet medications make platelets less likely to clump and form clots. (Platelets are tiny cell-like particles in the blood that help it clot in response to damaged blood vessels.) Takingclopidogrelplusaspirinappears to reduce the risk of future strokes more than takingaspirinalone, but only for the first 3 months after a stroke. After that, the combination has no advantage over takingaspirinalone. Also, takingclopidogrelplusaspirinincreases the risk of bleeding by a small amount. If a blood clot from the heart caused the TIA, anticoagulants, such aswarfarin, are given to make blood less likely to clot.Dabigatran,apixaban, andrivaroxabanare newer anticoagulants that are often used instead ofwarfarin. These newer anticoagulants are more convenient to use because they, unlikewarfarin, do not require regular monitoring with blood tests to measure how long it takes blood to clot. Also, they are not affected by foods and are unlikely to interact with other medications. But the new anticoagulants have some disadvantages.Dabigatranandapixabanmust be taken twice a day. (Warfarinis taken once a day.) Also, people must not miss any doses of the newer medications for the medications to be effective, and these medications are significantly more expensive thanwarfarin. 