Medications

Treatments for PAD help manage leg pain and improve function, as well as reduce the risk for heart attack and stroke. Drugs used for improving leg pain and function are generally those that either prevent blood clots (typically antiplatelet drugs) or improve blood flow.

Aspirin and Other Antiplatelet Drugs

Antiplatelet drugs such as aspirin reduce the risk for blood clots. Most patients with peripheral artery disease receive antiplatelet medication. For the most part, this recommendation is made to prevent future death from heart attack or stroke. (However, recent studies have indicated that aspirin may not have much benefit in preventing heart attack or stroke in patients with PAD.) Antiplatelet drugs may or may not provide benefit for PAD symptoms and progression.

Aspirin is usually the recommended first-line choice. Clopidogrel (Plavix) is recommended as an alternative.

Dipyridamole (Persantine) may help prevent complications of PAD when taken along with aspirin. Studies are mixed on the benefits of the combination. Without aspirin, the drug does not appear to have any advantages for patients with PAD.

Research indicates that adding an anticoagulant drug, such as warfarin (Coumadin), to antiplatelet therapy does not help prevent heart complications of PAD, and can increase the risks for life-threatening bleeding.

[For more information on these drugs, see In-Depth Report #03: Coronary artery disease.]

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Review Date: 04/05/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)