Dipyridamole

Aka: Dipyridamole, Persantine, Aggrenox

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II. Indications

  1. Cerebrovascular Accident Prevention after TIA or CVA
  2. Alternative for Aspirin sensitive patient
    1. Use Dipyridamole alone (Aggrenox contains Aspirin)
  3. Pharmacologic Stress Test
    1. Persantine or Dipyridamole Nuclear Stress Test is an alternative to Adenosine stress test
    2. Dipyridamole is a less potent vasodilator than Adenosine and may be better tolerated

III. Contraindications

  1. Creatinine Clearance <10 ml/min

IV. Mechanism

  1. Dipyridamole is a pyrimiopyrimidine derivative
  2. Inhibits Platelet phosphodiesterase to increase cAMP levels
    1. Potentiates Platelet aggregation inhibitor (PGI2)
  3. Inhibits Platelet uptake of Adenosine
    1. Inhibits Adenosine Diphosphate (ADP) induced Platelet aggregation

V. Dosing

  1. Dipyridamole (Persantine) alone
    1. Dose: 75 mg PO qid
  2. Aggrenox (Dipyridamole 200 mg and Aspirin 25 mg)
    1. Swallow whole (do not crush or chew)
    2. Take 1 capsule twice daily

VI. Drug Interactions

  1. Increased Bleeding risk when combined with other agents
    1. Anticoagulants
    2. Other antiplatelet agents
    3. NSAIDs

VII. Adverse Effects

  1. Adverse effects typically abate with continued use
  2. Diarrhea
  3. Dizziness or Syncope
  4. Rash
  5. Angina
  6. Headache
    1. Headache may be severe
    2. Responsible for high discontinuation rate

VIII. Safety

  1. Dipyridamole (Persantine)
    1. Pregnancy Category B
    2. Unknown safety in Lactation
  2. Aggrenox (Dipyridamole 200 mg and Aspirin 25 mg)
    1. Pregnancy Category D
    2. Unknown safety in Lactation

IX. Efficacy

  1. More effective than Aspirin alone after TIA or CVA in preventing recurrent vascular death, stroke, MI
    1. (2006) Lancet 367:1665 [PubMed]
  2. Not more effective than Clopidogrel in preventing recurrent stroke
    1. Sacco (2008) N Engl J Med 359: 1238 [PubMed]

X. Resources

  1. Dipyridamole Tablet (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a18b2af5-7c4a-4b7f-92c7-8a76e34da373
  2. Dipyridamole and Aspirin or Aggrenox (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=369cb8a3-e1e4-4150-859d-4f788436ddca
  3. Dipyridamole Injection (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6093dcd9-82d2-414f-8507-eda22c14f626

XI. References

  1. (2014) Med Lett Drugs Ther 56(1454):103-8 [PubMed]

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Related Studies

Cost: Medications

dipyridamole (on 6/22/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
DIPYRIDAMOLE 50 MG TABLET Generic $1.34 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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