Treatment and prevention of cerebral circulation disorders by ischemic type; dyscirculatory encephalopathy; prevention of arterial and venous thrombosis, as well as their complications; prevention of thromboembolism after heart valve replacement surgery; prevention of placental insufficiency in complicated pregnancy; as part of complex therapy for any microcirculation disorders.
active substance: dipyridamole
1 ml dipyridamole 5 mg
excipients: tartaric acid, propylene glycol, water for injection.
DIPIRIDAMOL DOSAGE FORM
DIPIRIDAMOL MAIN PHYSICAL AND CHEMICAL PROPERTIES:
transparent yellow liquid.
Antithrombotic agents. Antiplatelet agents. ATX code B01A C07.
Pharmodynamics. Dipyridamole dilates the coronary vessels, increases the volumetric rate of coronary blood flow, improves the supply of oxygen to the myocardium, and increases its resistance to hypoxia. It helps to improve blood circulation in the collateral vasculature in case of violations of this in the main coronary vessels. Reduces the total peripheral vascular resistance, slightly reduces systemic blood pressure, improves cerebral circulation. Dipyridamole is a competitive inhibitor of adenosine deaminase, an enzyme that breaks down adenosine and promotes an increase in the formation of adenosine, which is involved in the autoregulation of coronary blood flow. The drug inhibits platelet aggregation and prevents thrombus formation. This effect is apparently due to the stimulation of prostacyclin synthesis and inhibition of thromboxane biosynthesis. With an increase in the production of prostacyclin in the vascular wall, the effect of the drug on the metabolism of arachidonic acid is associated. The antiplatelet activity of dipyridamole is similar to that of acetylsalicylic acid.
Pharmacokinetics. Bioavailability is 37-66%. The time to reach the maximum concentration in the blood is 40-60 minutes. The connection with blood plasma proteins is 80-95%. Penetrates quickly into tissues. It is metabolized in the liver to form monoglucuronide, which is excreted in the bile.
As an antiplatelet agent for the prevention of postoperative thrombosis, cerebrovascular accident.
Hypersensitivity to the components of the drug. Widespread atherosclerosis of the coronary arteries, acute myocardial infarction, decompensated heart failure, arrhythmias, arterial hypotension (collapse), unstable angina pectoris, subaortic stenosis, renal failure, bronchial asthma, obstructive pulmonary disease, severe hepatic failure (hemorrhagic diathesis, diseases with peptic ulcer of the stomach and duodenum).
INTERACTION WITH OTHER DRUGS AND OTHER INTERACTIONS
Dipyridamole is incompatible with xanthine derivatives.
The simultaneous use of Dipyridamole with cholinesterase inhibitors can worsen the course of the disease in patients with myasthenia gravis.
The use of the drug with heparin increases the risk of hemorrhagic complications.
Dipyridamole increases the hypotensive effect of antihypertensive drugs, weakens the anticholinergic properties of cholinesterase inhibitors.
Dipyridamole increases plasma adenosine levels and its cardiovascular effects. In this regard, a dose adjustment of adenosine may be required.
FEATURES OF APPLICATION
For parenteral administration, do not allow the drug to get under the skin (possibly irritative effect).
Liver failure. The use of high doses of dipyridamole can lead to an increase in liver enzymes and liver failure.
There is no data on the use of the drug in elderly patients with hepatic or renal failure, therefore, in these cases, it should be used with caution.
Arterial hypotension. Dipyridamole should be used with caution in patients with arterial hypotension due to the fact that it can cause peripheral vasodilation.