What you need to know
- After a transient ischaemic attack (TIA) or stroke, your risk of having another one is higher.
- Almost everyone will need to take medication to reduce this risk.
- Never stop taking your medication or change your dose without talking to your doctor.
Blood pressure medication
High blood pressure is the biggest risk factor for stroke. Keeping your blood pressure in the normal range is very important. Normal blood pressure is around 120/80, so if your blood pressure is regularly over 140/80, you have high blood pressure.
If your blood pressure is too high, your arteries can thicken over time. They become weaker, less flexible or more prone to clots, and this can cause a stroke.
Medicines that lower your blood pressure are called anti-hypertensives. Almost everyone who has had a TIA or stroke should take anti-hypertensives, even if their blood
pressure is normal. Your doctor will work with you to find out the best medication for you.
Cholesterol-lowering medication
High cholesterol can lead to fatty build-up in the artery walls that narrows or blocks the artery to the brain, causing a stroke. Statins are the most common type of medication used to control cholesterol levels.
Statins are effective in reducing the risk of ischaemic stroke (strokes caused by a blocked blood vessel) regardless of cholesterol level. Higher dose statins are the most effective, so statins are usually prescribed at high doses, even for people with normal cholesterol levels.
Blood thinning medication
Blood clots can travel through the bloodstream and block an artery in the brain, causing a stroke. Blood-thinning medication lowers the risk of blood clots forming. If you have had a TIA or an ischaemic stroke you will almost always need to take blood-thinners.
There are two types of blood thinners:
Antiplatelet medication
Antiplatelet medicines stop tiny blood cells called platelets from sticking together and forming a blood clot. They are also called platelet aggregation inhibitors. They include aspirin, a combination of aspirin and dipyridamole, and clopidogrel.
Anticoagulant medicine
Anticoagulants stop your blood forming clots in a different way. Anticoagulants include direct-acting oral anticoagulants such as dabigatran, apixaban and rivaroxaban.
Warfarin is also an anticoagulant. If you take warfarin, you may need regular blood tests to check the amount of warfarin in your blood. There will also be some dietary restrictions.
If you have atrial fibrillation (irregular heart beat) or certain heart conditions such as a prosthetic heart valve, you should take anticoagulant medication. Take your medication regularly and don’t miss a dose. Your stroke risk goes up very quickly if you miss doses.
Blood thinners can make you bleed more easily. Tell your doctor you are taking blood thinners before you have medical treatments or surgery.
Managing your medications
- Take your medications at the same time every day.
- Being able to see your medications will help you remember. Making them part of your routine helps too. So if you need to take them in the morning, keep them on the counter where you make breakfast.
- Keep your medications in a place you always visit at the time you need to take them.
- Use a dosette box that shows the day of the week and time of day. You can also ask your pharmacist to pack all your medicines into a blister or webster pack.
- You can set alarms to remind you to take your medications using a regular clock or a smartphone.
- If you have a smartphone, there are apps that remind you to take your medications and when you are due for a refill or a new script. These apps make it easy to show
the doctors a list of your medicines if you go into hospital.
Travelling
Take enough medication for your entire trip and keep a few days’ supply with you in your hand luggage. Take a list of your medicines and the dose in case you need to see a doctor while travelling.
Side effects and interactions
If your doctor prescribes a medicine, keep taking it until they tell you to stop.
It can be dangerous to suddenly stop taking medicines or change the dose.
If you are worried or have questions about your medications speak to your doctor or pharmacist.
Sometimes medicines do not work as they are supposed to. Tell your doctor or pharmacist about everything you are taking, including over-the-counter medicines, natural remedies and vitamins. Your doctor may be able to make changes to reduce or eliminate any side effects or interactions. Your doctor can also organise a medication management review if needed.
Getting help
StrokeLine provides advice on stroke prevention, treatment and recovery. Call 1800 787 653 Monday to Friday 9am to 5pm, AEST (Australian Eastern Standard Time). Email strokeline@strokefoundation.org.au
EnableMe can help with your stroke recovery and life after stroke. Visit enableme.org.au
Medicines Line provides information on how medicines work, how to take them, side effects and interactions, and storage of medicines. 1300 633 424 nps.org.au