Indicated as an adjunct to coumarin anticoagulants in the prevention of postoperative thromboembolic complications of cardiac valve replacement.
Dipyridamole likely inhibits both adenosine deaminase and phosphodiesterase, preventing the degradation of cAMP, an inhibitor of platelet function. This elevation in cAMP blocks the release of arachidonic acid from membrane phospholipids and reduces thromboxane A2 activity. Dipyridamole also directly stimulates the release of prostacyclin, which induces adenylate cyclase activity, thereby raising the intraplatelet concentration of cAMP and further inhibiting platelet aggregation.
Secondary prevention of ischaemic stroke (not associated with atrial fibrillation) and transient ischaemic attacks (used alone or with aspirin) | Adjunct to oral anticoagulation for prophylaxis of thromboembolism associated with prosthetic heart valves BY MOUTH USING MODIFIED-RELEASE MEDICINES Adult: 200 mg twice daily, to be taken preferably with food Adjunct to oral anticoagulation for prophylaxis of thromboembolism associated with prosthetic heart valves BY MOUTH USING IMMEDIATE-RELEASE MEDICINES Adult: 300-600 mg daily in 3-4 divided doses Myocardial imaging-diagnostic use only BY INTRAVENOUS INJECTION Adult: (consult product literature).
Dipyridamole increases the plasma levels and cardiovascular effects of adenosine. Adjustment of adenosine dosage should therefore be considered if use with dipyridamole is unavoidable. There is evidence that the effects of acetylsalicylic acid and dipyridamole on platelet behaviour are additive. When dipyridamole is used in combination with anticoagulants or acetylsalicylic acid, the statements on intolerance and risks for these preparations must be observed. Addition of dipyridamole to acetylsalicylic acid does not increase the incidence of bleeding events. When dipyridamole was administered concomitantly with warfarin, bleeding was no greater in frequency or severity than that observed when warfarin was administered alone. Dipyridamole may increase the hypotensive effect of blood pressure lowering drugs and may counteract the anticholinesterase effect of cholinesterase inhibitors thereby potentially aggravating myasthenia gravis.
Aortic stenosis . coagulation disorders . heart failure . hypotension . left ventricular outflow obstruction . may exacerbate migraine . myasthenia gravis (risk of exacerbation) . rapidly worsening angina . recent myocardial infarction.
Angioedema, dizziness, Gastro-intestinal effects, Hot flushes, Hypersensitivity reaction, hypotension, increased bleeding after surgery, increased bleeding during surgery, myalgia, rash, severe bronchospasm, tachycardia, throbbing headache, thrombocytopenia, urticaria, worsening symptoms of coronary heart disease
PREGNANCY Not known to be harmful. BREAST FEEDING Manufacturers advise use only if essential?small amount present in milk.
Due to the low number of observations, experience with dipyridamole overdose is limited. Symptoms such as feeling warm, flushes, sweating, accelerated pulse, restlessness, feeling of weakness, dizziness, drop in blood pressure and anginal complaints can be expected.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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