Table 1.

Comparison of the mechanism of action, common and major adverse events, and out-of-pocket cost of common anti-platelet medications used in stroke prevention.

Medication	Mechanism of action	Most common adverse events*	Major adverse events	Monthly cost**
Cilostazol	Reversible intracellular PDE3 inhibition	Headache, diarrhea, palpitation, dizziness, tachycardia	Contraindicated in patients with heart failure	$9.00
Dipyridamole	Reversible intracellular PDE5 inhibition	Headache, dizziness, abdominal distress, angina pectoris, nausea	Major bleeding (when combined with aspirin)	$73.54
Aspirin	Irreversible extracellular inhibition of COX	Dyspepsia, rash, minor bleeding, epistaxis	Major bleeding, upper gastrointestinal ulcers	$2.47
Clopidogrel	Irreversible extracellular inhibition of P2Y12	Bruising, minor bleeding, epistaxis	Major bleeding	$15.00
Ticagrelor	Irreversible extracellular inhibition of P2Y12	Dyspnea, ventricular pause, nausea, dizziness, transient creatinine increase, minor bleeding	Major bleeding, bradyarrhythmia, thrombotic thrombocytopenic purpura	$373.90
Prasugrel	Irreversible extracellular inhibition of P2Y12	Hypertension, headache, nausea, minor bleeding, epistaxis	Fatal bleeding, thrombotic thrombocytopenic purpura	$32.36

^*According to Lexicomp (online.lexi.com).

^**According to goodrx.com, in the United States, without insurance, at Walmart.