Dipyridamole

What is Dipyridamole?

• Dipyridamole (Permole; Persantine) is a platelet inhibitor, used with other drugs to reduce the risk of blood clots after heart valve replacement.
• Dipyridamole is also used with aspirin to reduce the risk of death after a heart attack and to prevent another heart attack.

Dipyridamole

Dipyridamole 200

Dipyridamole-from-xtal-Mercury-3D-balls

What are the uses of this medicine?

Dipyridamole (Permole; Persantine) is used as an adjunct to coumarin anticoagulants in the prevention of postoperativethromboembolic complications of cardiac valve replacement.

How does this medicine work?

• Dipyridamole inhibits the uptake of adenosine into platelets, endothelial cells and erythrocytes.
• The inhibition occurs in a dose-dependent manner.
• This inhibition results in an increase in local concentrations of adenosine which acts on the platelet A2-receptor thereby stimulating platelet adenylate cyclase and increasing platelet cyclic-3',5'-adenosine monophosphate (cAMP) levels.
• This mechanism, platelet aggregation is inhibited in response to various stimuli such as platelet activating factor (PAF), collagen and adenosine diphosphate (ADP).
• Dipyridamole inhibits phosphodiesterase (PDE) in various tissues.
• While the inhibition of cAMP-PDE is weak, therapeutic levels of dipyridamole inhibit cyclic-3',5'-guanosine monophosphate-PDE (cGMP-PDE), thereby augmenting the increase in cGMP produced by EDRF (endothelium-derived relaxing factor, now identified as nitric oxide).

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• Hypersensitivity to dipyridamole and any of the other components.

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Especially tell your doctor if you take:

• aspirin
• Adenosinergic agents (e.g., adenosine, regadenoson)
• Cholinesterase Inhibitors

Is this medicine FDA approved?

• Dipyridamole was approved for use in the United States in 1961 as an adjunct to coumarin Anticoagulants in prevention of thromboembolic complications of cardiac valve replacements.

How should this medicine be used?

Recommended dosage:

• The recommended dose is 75 mg to 100 mg four times daily as an adjunct to the usual warfarin therapy.
• Aspirin is not to be administered concomitantly with coumarin anticoagulants.

Administration:

• Dipyridamole comes as a tablet to take by mouth.
• It is usually taken 4 times a day.
• This medication is sometimes prescribed for other uses.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Dipyridamole Tablets USP, 25 mg; 50mg; 75mg

This medicine is available in fallowing brand namesː

• Permole; Persantine

What side effects can this medication cause?

The most common side effects of this medicine include:

• Dizziness
• Abdominal distress
• Headache
• Rash
• diarrhea
• vomiting
• flushing
• pruritus

Less coomon side effects may include:

• angina pectoris, hypersensitivity reactions (such as rash, urticaria, severe bronchospasm, and angioedema), larynx edema, fatigue, malaise, myalgia, arthritis, nausea, dyspepsia, paresthesia, hepatitis, thrombocytopenia, alopecia, cholelithiasis, hypotension, palpitation, and tachycardia.

What special precautions should I follow?

• Dipyridamole has a vasodilatory effect and should be used with caution in patients with severe coronary artery disease. Chest pain may be aggravated in patients with underlying coronary artery disease who are receiving dipyridamole.
• Elevations of hepatic enzymes and hepatic failure have been reported in association with dipyridamole administration.
• Dipyridamole should be used with caution in patients with hypotension since it can produce peripheral vasodilation.
• Patients being treated with dipyridamole tablets who also require pharmacological stress testing with intravenous dipyridamole or other adenosinergic agents (e.g. adenosine, regadenoson) should interrupt dipyridamole tablets for 48 hours prior to stress testing.
• Intake of dipyridamole tablets within 48 hours prior to stress testing with intravenous dipyridamole or other adenosinergic agents may increase the risk for cardiovascular side effects of these agents and may impair the sensitivity of the test.
• As dipyridamole is excreted in human milk, caution should be exercised when dipyridamole tablets are administered to a nursing woman.
• Dipyridamole is associated with a low rate of serum enzyme elevations during treatment, but has not been linked to instances of clinically apparent acute liver injury.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• warm feeling, flushes, sweating, restlessness, feeling of weakness and dizziness.
• A drop in blood pressure and tachycardia might also be observed.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• Symptomatic treatment is recommended, possibly including a vasopressor drug.
• Gastric lavage should be considered.
• Administration of xanthine derivatives (e.g., aminophylline) may reverse the hemodynamic effects of dipyridamole overdose.
• Since dipyridamole is highly protein bound, dialysis is not likely to be of benefit.

Can this medicine be used in pregnancy?

• There are, however, no adequate and well-controlled studies in pregnant women.
• Because animal reproduction studies are not always predictive of human response, dipyridamole tablets should be used during pregnancy only if clearly needed.

Can this medicine be used in children?

• Safety and effectiveness in the pediatric population below the age of 12 years have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• Dipyridamole

Inactive ingredients:

• colloidal silicon dioxide, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, povidone, pregelatinized starch, sodium starch glycolate, Type A, talc, and titanium dioxide.

Who manufactures and distributes this medicine?

Manufactured by:

• Amneal Pharmaceuticals Pvt. Ltd.
• Oral Solid Dosage Unit
• Ahmedabad, INDIA

Distributed by:

• Amneal Pharmaceuticals LLC
• Bridgewater, NJ

What should I know about storage and disposal of this medication?

• Store at 20° to 25°C (68° to 77°F).
• Keep this and all medication out of the reach of children.
• Dispense in tightly-closed, light-resistant container as defined in the USP, with child-resistant closure, as required.

• Dailymed label info on Dipyridamole
• FDA Dipyridamole