Ischemic Stroke Drug Summary

Last updated: 11 March 2025
Reviewed by

ACE Inhibitor


Drug Dosage Remarks
Perindopril Reduction of stroke recurrence:
2.5 mg PO 24 hrly for 2 wk,
then increase to 5 mg PO 24 hrly for a
further 2 wk before
introducing Indapamide
 Adverse Reactions
  • Hematologic effects (neutropenia, agranulocytosis, anemia, thrombocytopenia); Other effects (cholestatic jaundice, hypotension, syncope, hyperkalemia, cough)
Special Instructions
  • Contraindicated in patients w/ history of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema, bilateral or unilateral renal stenosis; concomitant use w/ Aliskiren-containing products in patients w/ DM or renal impairment 
  • Use w/ caution in patients w/ hypertrophic cardiomyopathy, salt or volume depletion, collagen vascular disease, severe aortic & mitral valve stenosis, diabetes, CV disease

Calcium Channel

Drug Dosage Remarks
Perindopril Reduction of stroke recurrence: 2.5 mg PO q24h for 2 weeks, then increase to 5 mg PO q24h for a further 2 weeks before introducing Indapamide. Adverse Reactions
  • Hematologic: leukopenia.
  • Other effects: angioedema, cough, fever, headache, and wheezing.
Special Instructions
  • Contraindicated in pregnancy, bilateral renal artery stenosis, history of angioedema.
  • Use with caution in patients with renal impairment (risk of hyperkalemia), dehydration, and at risk for symptomatic hypotension.

Other ACE

Drug Dosage Remarks
Perindopril Reduction of stroke recurrence: 2.5 mg PO 24 hrly for 2 wk, then increase to 5 mg PO 24 hrly for a further 2 wk before introducing Indapamide Adverse Reactions
  • Hematologic eff ects (neutropenia, agranulocytosis, anemia, thrombocytopenia); Other eff ects (cholestatic jaundice, hypotension, syncope, hyperkalemia, cough)
Special Instructions
  • Contraindicated in patients w/ history of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema, bilateral or unilateral renal stenosis; concomitant use w/ Aliskiren-containing products in patients w/ DM or renal impairment
  • Use w/ caution in patients w/ hypertrophic cardiomyopathy, salt or volume depletion, collagen vascular disease, severe aortic & mitral valve stenosis, diabetes, CV disease

Anticoagulants

Drug Table
Drug Dosage Remarks
Perindopril Reduction of stroke recurrence: 2.5 mg PO 24 hrly for 2 wk, then increase to 5 mg PO 24 hrly for a further 2 wk before introducing Indapamide
Adverse Reactions
  • Hematologic effects (neutropenia, agranulocytosis, anemia, thrombocytopenia); Other effects (cholestatic jaundice, hypotension, syncope, hyperkalemia, cough)
Special Instructions
  • Contraindicated in patients w/ history of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema, bilateral or unilateral renal stenosis; concomitant use w/ Aliskiren-containing products in patients w/ DM or renal impairment
  • Use w/ caution in patients w/ hypertrophic cardiomyopathy, salt or volume depletion, collagen vascular disease, severe aortic & mitral valve stenosis, diabetes, CV disease

ACE too

Drug Dosage Remarks
Perindopril Reduction of stroke recurrence: 2.5 mg PO 24 hrly for 2 wk, then increase to 5 mg PO 24 hrly for a further 2 wk before introducing Indapamide Adverse Reactions
  • Hematologic eff ects (neutropenia, agranulocytosis, anemia, thrombocytopenia); Other eff ects (cholestatic jaundice, hypotension, syncope, hyperkalemia, cough)
Special Instructions
  • Contraindicated in patients w/ history of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema, bilateral or unilateral renal stenosis; concomitant use w/ Aliskiren-containing products in patients w/ DM or renal impairment
  • Use w/ caution in patients w/ hypertrophic cardiomyopathy, salt or volume depletion, collagen vascular disease, severe aortic & mitral valve stenosis, diabetes, CV disease

ACE III

Drug Dosage Remarks
Perindopril Reduction of stroke
recurrence: 2.5 mg
PO 24 hrly for 2 wk,
then increase to 5 mg
PO 24 hrly for a
further 2 wk before
introducing
Indapamide		 Adverse Reactions
  • Hematologic eff ects (neutropenia, agranulocytosis, anemia, thrombocytopenia); Other eff ects (cholestatic jaundice, hypotension, syncope, hyperkalemia, cough)
Special Instructions
  • Contraindicated in patients w/ history of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema, bilateral or unilateral renal stenosis; concomitant use w/ Aliskiren-containing products in patients w/ DM or renal impairment
  • Use w/ caution in patients w/ hypertrophic cardiomyopathy, salt or volume depletion, collagen vascular disease, severe aortic & mitral valve stenosis, diabetes, CV disease

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