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Medication after stroke

Fact sheet
If you have had a stroke or transient ischaemic attack (TIA), also known as a mini-stroke, you have a greater chance of having a second stroke or TIA. There are several things you can do to lower the chance of having another stroke including reducing your blood pressure and cholesterol, quitting smoking, exercising regularly, eating healthy foods and taking the right medications.

Medication to prevent stroke

There are many different medications your doctor may prescribe to reduce your risk of having another stroke or TIA. It is important that you understand: what medication(s) you are taking why you are taking them how and when you should take them (eg. with or without food) any side effects of your medication what happens if you suddenly stop taking your medication.

All people with a previous stroke or TIA should be on medication to reduce blood pressure. Blood pressure therapy is recommended even if your blood pressure is normal. This reduces your risk of subsequent events. There are different types of blood pressure-lowering medications. Your doctor will work with you to nd the medication, or the combination of medications, that is best for you. You may also be advised to modify your diet or increase the amount of exercise to help reduce your blood pressure (refer to the National Stroke Foundations High blood pressure and stroke brochure for more information).
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Blood pressure
High blood pressure is the most important risk factor for stroke. Keeping your blood pressure controlled is essential. Medications to reduce your blood pressure are called antihypertensives (anti = against + hypertensive = high blood pressure).

Blood thinners
Blood thinners help reduce the risk of blood clots forming which can lead to a stroke. There are two types of blood thinners: 1. Antiplatelet medication (Platelet Aggregation Inhibitors). This group of medications keep tiny cells (platelets) in the blood from sticking together and forming blood clots. There are three common types of antiplatelet medication including: Aspirin A combination of Aspirin and Dipyridamole and Clopidogrel Different medications may be prescribes depending on which ones are appropriate. 2. Anticoagulant medication also stops your blood from forming clots, however this medication uses a different chemical process. Common

examples include Heparin and Warfarin. If you are taking Warfarin, you may need to have your blood tested regularly to see if you have the right level of medication in your blood. Anticoagulant medication may also be prescribed if you have atrial brillation (irregular heart beat) or those with particular heart conditions (eg. a prosthetic heart valve). You may bleed more easily when taking these medications. It is important you try to prevent accidents or injuries (eg. falling over) or that you tell your health professional before undergoing other medical treatment (eg. surgery). Your doctor will help you decide the most effective medication for your condition.

Cholesterol
High cholesterol is another risk factor for stroke. You should take medication to lower your cholesterol if youve had an ischaemic stroke or TIA (blood clot).

You should also be given advice on how to lower your cholesterol by changing your diet, increasing regular exercise and/or reducing your wight. The most common type of medication to lower cholesterol is called statins. Please refer to the National Stroke Foundations High cholesterol and stroke brochure for more information.

Using a medication diary or daily chart to keep track of your medications. Your doctor will help you to work out the right medication, dosage and timing for your lifestyle. Never stop taking your medication or change how much you take without talking to your doctor. In some cases, suddenly stopping your medication can be dangerous.

Remembering your medication

If your doctor prescribes medication, it is important to continue taking it unless your doctor tells you to stop. If you have difculty remembering to take your medications then you can try: Taking your medication at the same time every day. It is important to get into a routine. Using a pillbox or dispenser that notes day and times. You can organise this with your local pharmacist.

Side effects
Medications occasionally have side effects. It is important to remember and report these to your doctor, no matter how big or small. In order to report these, you must rst understand the particular side effects your medications can produce. Your pharmacist or doctor can discuss these with you. Your doctor may be able to make changes that reduce or remove these side effects.

Other medication
You may be taking a number of medications for different reasons. For example, you may use injections or tablets to control your diabetes or you may take tablets for arthritis.

Sometimes prescribed medications will interact with and/or cause more side effects for overthe-counter medications or herbal remedies. It is important that you talk to your doctor or pharmacist about all the medications you are taking including natural remedies or vitamin supplements.

Risks you cannot change include, age (your risk of stroke increases as you get older), gender (women are more likely to have a stroke because they live longer) and family and/or personal history of stroke or heart problems. Risks you can change include, controlling and monitoring blood pressure and cholesterol levels, stopping smoking, eating a healthy diet, doing regular exercise, minimising your alcohol use, controlling and monitoring your diabetes.

Travelling
If you plan to travel, its a good idea to take a list of your medications with you. Ask your pharmacist or doctor to provide a list together with dosages. If you have to visit a doctor or hospital interstate or overseas, this list will ensure you are given the correct medication and dosage.

More information
Speak to your doctor, pharmacist or health professional if you have any further questions. Note: This fact sheet is number 5 in a series. For a complete list of fact sheets, visit www.strokefoundation.com.au

Know your stroke risk

Medication is only one aspect of lowering your risk of stroke. You should be aware of what else you can do to lower your risk.

National Stroke Foundation. ABN 420 061 733 79 Level 7, 461 Bourke Street, Melbourne VIC 3000. Phone: 03 9670 1000 Fax: 03 9670 9300 StrokeLine: 1800 787 653 Email: admin@strokefoundation.com.au www.strokefoundation.com.au
July 2008. This fact sheet was developed by the National Stroke Foundation.