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 tablet contains dipyridamole (in terms of 100% dry matter) – 25 mg;
Dipiridamol excipients: potato starch, lactose monohydrate, calcium stearate.
Dipiridamol Dosage form
Basic physical and chemical properties: round tablets with a biconvex surface, yellow with a greenish tinge.
Antithrombotic drugs. Antiplatelet agents. Dipyridamole. ATC code B01A C07.
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 such 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 synthesis of prostacyclin in the vascular wall, the effect of the drug on the metabolism of arachidonic acid is associated. The antiaggregatory activity of dipyridamole is similar to that of acetylsalicylic acid.
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.
Prevention and treatment of arterial and venous thrombosis and their complications (in particular, prevention of thromboembolism after heart valve replacement surgery);
ischemic cerebral circulation disorders;
violation of microcirculation (as part of complex therapy).
Hypersensitivity to dipyridamole or to other components of the drug;
acute myocardial infarction;
decompensated heart failure;
severe heart rhythm disturbances;
severe arterial hypotension (systolic pressure below 90 mm Hg);
hemorrhagic diathesis, diseases with a risk of bleeding (for example, gastric ulcer and duodenal ulcer);
severe renal or hepatic impairment;
widespread stenosing atherosclerosis of the coronary arteries;
subaortic aortic stenosis;
bronchial asthma, obstructive pulmonary disease.
Interaction with other medicinal products and other types of interactions
Adenosine: Dipyridamole inhibits the reuptake of adenosine and increases its plasma levels and cardiovascular effects (significant risk of toxicity). It is necessary to adjust the dose of adenosine while using.
Fludarabine: There may be a decrease in the absorption of fludarabine and a decrease in its effectiveness.
Coumarin-type anticoagulants, acetylsalicylic acid, heparin, clopidogrel, as well as β-lactam antibiotics (penicillins, cephalosporins), tetracyclines, chloramphenicol: increasing their anticoagulant, antiaggregatory effect. The combination of dipyridamole and coumarin anticoagulants, heparin does not alter prothrombin time, but may increase the risk of serious bleeding. The combination of dipyridamole with aspirin does not increase the incidence of bleeding. There is an increased risk of bleeding when clopidogrel is used with dipyridamole. When using the drug with acetylsalicylic acid or anticoagulants, information on the risks and incompatibility of these drugs should be taken into account.
Phenindione: The antiplatelet effect of dipyridamole increases the anticoagulant effect of phenindione.
Cholinesterase inhibitors: Dipyridamole can counteract the anticholinesterase effects of cholinesterase inhibitors, which can exacerbate myasthenia gravis.