Common Side Effects of Stroke Medications




A web-only companion piece to Understanding Common Post-Stroke Medications, Stroke Connection Fall 2017


First, some caveats: Patients can have a broad range of reactions to medication.  

Any reaction related to a change in medication can be hard to pin down when a patient is on a treatment regimen that includes several drugs. It’s important that patients carefully review the information their medical team, rehab team or pharmacist gives them about their medicines. This information can be especially helpful if they have questions after they leave the doctor’s office.
When starting a new medication, any signs of dizziness, rash, trouble breathing or other sign of allergic reaction should be immediately reported to your doctor or nearest hospital emergency department.

Many common post-stroke medications have overlapping side effects: It is important to note when a side effect started (did it occur after starting a new medication, for instance). That helps your healthcare provider identify which meds may be the culprit.

Patients should always discuss the short- and long-term side effects of any medication with their doctor or pharmacist and should never stop taking a prescribed medication without talking with the doctor first.

The following is in no way intended to be an exhaustive list of the side effects of the drugs mentioned. It is a quick list of some common ones. For more complete lists of side effects, talk with your pharmacist, visit the drug manufacturer’s website, or one of several other sites dedicated to educating patients about their medicines.  


Antiplatelets & Anticoagulants

Different antiplatelets and anticoagulants may have different effects. In general, bleeding is the major adverse effect.  Any sign of easier than normal bruising should be reported to your doctor for evaluation, as this could be an early symptom of a more serious problem. Some antiplatelets may cause stomach upset, or pain and nausea can arise with anticoagulants.

 

SSRI’s (common type of antidepressant) 

Common side effects include nausea, drowsiness, anxiety and restlessness. There are many types of SSRIs, if one is difficult for you, another may not be – and sometimes side effect symptoms get better on their own after a few weeks. 

 

Blood Pressure Meds 

This is a broad class of medicines that includes several different types. Most side effects from blood pressure medicines aren’t severe and, with time, may even stop. Coughing, diarrhea or constipation, nervousness and headache are common. Sometimes medication and dosage adjustments can help with side effects. Stay in communication with your healthcare provider about side effects, some of them may be a sign of something more serious. For example, dizziness in general or dizziness when standing quickly (orthostatic hypotension) or sitting up may be a sign of hypotension (blood pressure too low), something you definitely need to mention to your healthcare provider.  

 

Statins 

Statins not only help keep cholesterol in check, they also reduce the risk of heart attack and stroke. If you believe you’re having side effects, don’t stop taking your statins – talk with your healthcare provider. Making a change to your dosage or the type of medicine may help. 

Some patients may experience muscle weakness, tiredness, soreness or pain. Talk with your healthcare provider about this, switching to a different type of statin may help. If you have severe muscle pain – talk with your doctor immediately. 

Long term, there is a small possibility that these drugs may increase blood glucose levels or cause diabetes. This side effect is related to the type and intensity of statin therapy, and should be discussed with the doctor. For most, the benefits a statin provides will outweigh the small risk of blood sugar level increasing.

If grapefruit or grapefruit juice is part of your diet, talk with your doctor about how much you can have. There is a chemical in grapefruit that can interfere with how your body metabolizes statins in your digestive system.


It is very important to take your prescriptions as directed.

Many side effects can be minimized by taking the drug at a certain time of day, e.g. blood pressure meds taken at bedtime, or to take advantage of the body’s circadian rhythm. Many drugs also can be absorbed differently if taken on an empty stomach or with food. Taking medications as directed is important, and changing how they are taken should never be done without consulting your doctor or pharmacist.

These medications are prescribed in the doses and at the times they are because the science has shown them to work best when taken that way. Any deviation from these instructions should always be discussed with your healthcare provider. Don’t assume that “taking more” will increase the effect, or “taking less” will give you the same result with fewer side effects.  Never stop a long-term medication unless advised to do so by your healthcare professional.  

Source: Interview with Joseph W. Braviak, M.S., assistant vice president pharmacy services, Inpatient Rehabilitation Division, Select Medical.

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