What are the current NICE guidelines for the management and secondary prevention of TIA in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

People who have had a suspected TIA should be offered aspirin 300 mg immediately unless contraindicated, to be started as soon as possible, with a proton-pump inhibitor if dyspepsia occurs (NICE, 2019a; 2).

Immediately refer people who have had a suspected TIA for specialist assessment and investigation, to be seen within 24 hours of onset of symptoms (NICE, 2019a; 1).

Do not use scoring systems, such as ABCD2, to assess risk of subsequent stroke or to inform urgency of referral (NICE, 2019a; 1).

Offer secondary prevention, in addition to aspirin, as soon as possible after the diagnosis of TIA is confirmed (NICE, 2019a; 1).

In people with suspected TIA within the last week, offer aspirin 300 mg immediately unless contraindicated, and give a proton-pump inhibitor to those with dyspepsia (NICE, 2019a; 2).

Refer for specialist assessment within 24 hours of symptom onset (NICE, 2019a; 1).

Do not offer CT brain scanning to people with suspected TIA unless there is suspicion of an alternative diagnosis that CT could detect (NICE, 2019a; 1).

Educational content only. Always verify information and use clinical judgement.