Is this helpful? Yes·NoClick to see full answer. Moreover, does tPA affect INR?Because tPA may itself elevate the INR, it is unclear whether the slight increase reflected a delayed effect of recently ingested warfarin or the acute effects of tPA administration. Both cited studies focused on patients taking warfarin.Subsequently, question is, when should I start anticoagulation after tPA? Administration of aspirin is recommended in acute stroke patients within 24-48 hours after stroke onset. For patients treated with IV tPA, aspirin administration is generally delayed for 24 hours. Urgent anticoagulation (e.g., heparin drip) for most stroke patients is not indicated. Subsequently, question is, what are contraindications for tPA? Symptom onset is unknown, > 4.5 hours, or if patient awoke with stroke. ? Acute or previous intracranial hemorrhage. ? Imaging showing extensive regions of irreversible injury (hypoattenuation) ? Prior ischemic stroke, severe head trauma, or intracranial/intraspinal surgery within 3 months. Can you give tPA with Plavix?The neurology and ED teams have decided to give tissue plasminogen activator (tPA). As the comorbidities between cardiac disease and cerebrovascular disease often overlap, ischemic stroke patients getting tPA may commonly be taking aspirin monotherapy or aspirin-clopidogrel combination therapy.