Recurrent TIA and stroke can be prevented.

What can you do to help prevent recurrent TIA and stroke? If you think you may be at risk, make an appointment with your doctor today. Talk about your risk factors and what you can do about them. In general, it's a good idea to:

Eat smart — a healthy diet, low in fat and including plenty of fruits and vegetables, may help protect against TIA and stroke.
Be more active — the benefits of regular exercise are well known, including improved circulation, weight loss, and reduced risk of heart disease.
Follow your doctor's advice — If you have high cholesterol or high blood pressure, your doctor can help you control these conditions through diet, exercise, and medicine.

In addition, there are medicines your doctor can prescribe to help prevent recurrent TIA and stroke. Ask your doctor which medicines are most effective.

The two major types of treatments your doctor can choose from are:

Anticoagulants - also known as "blood thinners" — delay and prevent blood clot formation
Antiplatelets - interfere with clotting by preventing platelets from sticking together

Medication Type: Examples; Anticoagulants: Warfarin, Heparin; Antiplatelets: AGGRENOX, Aspirin, Clopidogrel, Ticlopidine

AGGRENOX (aspirin/extended-release dipyridamole)

AGGRENOX is indicated to reduce the risk of stroke in patients who have had transient ischemia of the brain or completed ischemic stroke due to thrombosis.

AGGRENOX contains two effective medicines:

200 mg of extended-release dipyridamole
25 mg of aspirin

Aspirin works by reducing the production of prostaglandins. These are natural substances in the body that help platelets stick together to form blood clots. Dipyridamole works in a different way to prevent clots from forming.

Together in AGGRENOX, these two ingredients are more effective than either one alone. In fact, AGGRENOX lowers the risk of stroke twice as well as aspirin.

Aspirin and generic dipyridamole cannot be used as a substitute for AGGRENOX. When these two medicines are combined in the AGGRENOX capsule, they create a powerful combination treatment that helps prevent clots from forming and causing a stroke. More...

Aspirin

Aspirin is the most widely used antiplatelet drug because of its effectiveness and low cost.* Aspirin works by reducing the production of prostaglandins. These are natural substances in the body that help platelets stick together to form blood clots.

Patients who have a history of active ulcer disease should not take aspirin. Even low doses of aspirin can increase the time it takes for the body to form the clots that will stop bleeding. Regular heavy use of alcohol may increase bleeding risk, as may aspirin usage in combination with warfarin or heparin.

Clopidogrel Bisulfate

Clopidogrel bisulfate, sold under the name Plavix® helps prevent platelets from starting a blood clot. It is used to reduce or prevent the risk of recurrent stroke, myocardial infarction (heart attack), and other vascular disease in patients who have had a previous event.^1,2

Like aspirin, clopidogrel should not be used in patients who have active peptic ulcer disease. Clopidogrel should be used with caution in patients who may have increased risk for bleeding from trauma, surgery, or other drug conditions.²

Clopidogrel may interfere with the development of certain white blood cells called neutrophils. This rarely occurs, but when it does, the individual becomes prone to infection and may develop fever or other symptoms.² If you would like to know more about clopidogrel, please talk to your doctor.

Ticlopidine Hydrochloride

Ticlopidine hydrochloride, sold under the name Ticlid®, works in much the same way as clopidogrel and is used to reduce the risk of ischemic stroke in patients who have experienced ischemic stroke or transient ischemic attacks of the brain (TIAs, also called "mini-strokes").^1,3

According to the recently conducted African American Antiplatelet Stroke Prevention Study (AAASPS), there was no significant difference between the effectiveness of ticlopidine and aspirin in the prevention of another stroke. The study was stopped early because there was concern for the safety of patients.³

As with other antiplatelet drugs, ticlopidine should be used with caution in patients who have active peptic ulcer disease or other bleeding risks. Individuals who take ticlopidine must have regular blood tests performed when they begin taking the drug.³ Ticlopidine may limit the development of certain white blood cells and platelets. A shortage of white blood cells may allow a severe infection to occur; with a shortage of platelets, internal bleeding may be fatal. For more information about ticlopidine, please consult your doctor.

Plavix® is a registered trademark of Sanofi-Synthelabo.
Ticlid® is a registered trademark of Sanofi-Aventis Corporation.

¹Albers GW, Hart RG, Lutsep HL, et al. AHA Scientific Statement, Supplement to the guidelines for the management of transient ischemic attacks: a statement from the Ad Hoc Committee on Guidelines for the Management of Transient Ischemic Attacks, Stroke Council, American Heart Association. Stroke. 1999;30:2502-2511.
²Plavix® (clopidogrel bisulfate) Prescribing Information, New York, NY: Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership; 2002.
³Ticlid® (ticlopidine hydrochloride) Prescribing Information, Nutley, NJ: Roche Laboratories, Inc; 2001.

*The professional labeling for aspirin recommends 50 mg- 325 mg per day for stroke prevention. This regimen has been endorsed by the
American Heart Association, the National Stroke Association, and the American College of Chest Physicians.

HOW TO LOWER YOUR RISK

See your doctor for regular checkups. Your doctor can pinpoint your risk factors and identify the right treatments and lifestyle changes to help reduce your risk of a recurrent TIA or stroke.