For many people who have heart conditions or a history of strokes, therapy and lifestyle changes are not enough; medication is a necessity. Stroke prevention medication saves lives.
Learning the risks of certain drugs will help to reduce the likelihood of hazardous events while you are adjusting to new stroke medication.
Types of Stroke Prevention Medications
There are two primary categories of stroke prevention medications: antiplatelet agents and anticoagulants. Both of these types of drugs work to keeps clots from forming and inhibit the growth of existing clots. They work by different mechanisms and come with varying degrees of risk.
Antiplatelet agents slow the production of thromboxane, a chemical that signals for platelets to stick together and form clots. Aspirin, clopidogrel, dipyridamole and ticlopidine are all common antiplatelet agents.
Anticoagulants target clotting factors, which are proteins made in the liver. These are recommended to patients with a high risk of stroke and atrial fibrillation (AF). Warfarin, Pradaxa, Xarelto and Eliquis are all anticoagulants.
Risks associated with Antiplatelet Agents
Not everyone will benefit from antiplatelet therapy; some people will need to take adjusted doses or use alternative medications. People with a history of the following conditions should consult their doctor before taking these drugs:
- a history of liver disease
- a history of kidney disease
- high blood pressure
- bleeding disorders
- gastrointestinal diseases
- peptic ulcers
Antiplatelet agents are also not recommended for people who have haemorrhagic strokes (bleeding in the brain).
Risks associated with Anticoagulants
Many patients take warfarin, which has been the staple anticoagulant for decades, but they must follow strict guidelines. First, patients require regular blood tests that measure your International Normalized Ratio (INR), reflecting the time it takes for your blood to clot. Patients also have to monitor their intake of certain foods that can reduce the efficacy of warfarin.
The following foods should be monitored:
- Spinach, cabbage and lettuce
- Brussels sprouts
- Turnip, collard and mustard greens
- Green onions
All of these foods contain vitamin K, which inhibits warfarin’s blood-clotting mechanism. As long as the consumption of these foods is monitored, warfarin can be used. Also, if there are bleeding emergencies that arise during warfarin use, a hospital can administer vitamin K to stop the bleeding.
Anticoagulants without Bleeding Antidotes
Pradaxa, Xarelto and Eliquis are anticoagulants –also known as blood thinners—all made available for use within the last three years. None of them has an antidote, putting users at risk for uncontrollable bleeding accidents.
Falls, small cuts, minor wounds, surgeries, internal and external bruises, and other accidents can quickly escalate into emergency situations. Even with hospitalization and medical care, some patients do not survive these events.
In 2011, there were 542 deaths related to Pradaxa use. Some of these were related to hemorrhaging , while others may have been the result of heart problems. Multiple studies have shown that Pradaxa can increase the risk of heart attack and symptoms of heart disease.
Since Xarelto and Eliquis are newer additions to the blood thinner market, reports of adverse events are yet to be gathered.
Alanna Ritchie is a content writer for Drugwatch.com. She focuses on prescription drugs, medical devices and consumer safety.