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BMS-986177 + aspirin is a **combination of milvexian (BMS-986177)**, an oral, selective, reversible small molecule inhibitor of activated Factor XI (FXIa), and **aspirin (acetylsalicylic acid)**, a nonsteroidal anti-inflammatory drug (NSAID) that acts as an antiplatelet by irreversibly inhibiting cyclooxygenase-1 (COX-1) in platelets. This combination is under clinical investigation for the prevention of thromboembolic events such as ischemic stroke, particularly in patients with acute non-cardioembolic ischemic stroke or transient ischemic attack (TIA) in which both agents are administered together, sometimes alongside other antiplatelet therapies like clopidogrel. Milvexian is being developed by Bristol Myers Squibb in collaboration with Janssen Pharmaceuticals, and the combination has been evaluated for safety, pharmacokinetics, and pharmacodynamics in phase I and II clinical trials, demonstrating a favorable safety profile with no significant increase in clinically relevant bleeding compared to placebo or single-agent use.[1][2][3][5][7][9]
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