antiplatelet drugs for secondary prevention of stroke

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Patients with stroke or TIA should receive two weeks of aspirin followed by definitive anti-platelet treatment (1):

  • clopidogrel is recommended as an option to prevent occlusive vascular events:
    • for people who have had an ischaemic stroke or who have peripheral arterial disease or multivascular disease or
    • for people who have had a myocardial infarction only if aspirin is contraindicated or not tolerated

  • modified-release dipyridamole in combination with aspirin is recommended as an option to prevent occlusive vascular events:
    • for people who have had a transient ischaemic attack or
    • for people who have had an ischaemic stroke only if clopidogrel is contraindicated or not tolerated

  • modified-release dipyridamole alone is recommended as an option to prevent occlusive vascular events:
    • for people who have had an ischaemic stroke only if aspirin and clopidogrel are contraindicated or not tolerated or
    • for people who have had a transient ischaemic attack only if aspirin is contraindicated or not tolerated

People currently receiving clopidogrel or modified-release dipyridamole either with or without aspirin outside the criteria detailed above should have the option to continue treatment until they and their clinicians consider it appropriate to stop

Reference:

Last edited 04/2018 and last reviewed 04/2018

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