In most patients, aspirin in a dosage of 50 to 325 mg per day is the recommended initial agent for antiplatelet therapy.3,30

In patients who cannot tolerate aspirin, clopidogrel (Plavix) may be a good second choice; this agent currently is considered to be safer than ticlopidine (Ticlid).3

Rarely, thrombotic thrombocytopenic purpura has been reported with the use of ticlopidine and clopidogrel.27

Extended-release dipyridamole may potentiate the effect of very-low-dose aspirin therapy.29

Whether combined aspirin-dipyridamole (Aggrenox) provides equal or better stroke prevention than 325 mg per day of aspirin alone is not known.31