Drug information of Dipyridamole
Mechanism of effect
Lengthens abnormally shortened platelet survival time in a dose-dependent manner by inhibiting platelet aggregation in response to various stimuli, such as platelet activating factor, collagen, and adenosine diphosphate. Vasodilation may result from inhibition of adenosine uptake, which is an important mediator of coronary vasodilation.
Dipyridamole, a non-nitrate coronary vasodilator that also inhibits platelet aggregation, is combined with other anticoagulant drugs, such as warfarin, to prevent thrombosis in patients with valvular or vascular disorders. Dipyridamole is also used in myocardial perfusion imaging, as an antiplatelet agent, and in combination with aspirin for stroke prophylaxis.
Two minutes after a 4 min IV infusion, the mean serum level is 4.6 mcg/mL. Highly bound to plasma protein (99%). Vd is 1 to 2.5 L/kg. Metabolized in the liver (conjugated as a glucuronide). Excreted in the bile. Half life: 40 minutes. . Average total body Cl is 2.3 to 3.5 mL/min/kg.
Drug indications(oral)Adjunct to coumarin anticoagulants in prevention of postoperative thromboembolic complication of cardiac valve replacement , Alternative to exercise in thallium myocardial perfusion imaging for evaluating coronary artery disease in patients who cannot exercise adequately (IV)
Adjunctive Use in Prophylaxis of Thromboembolism after Cardiac Valve Replacement Adults and children 12 yr of age and older PO 75 to 100 mg 4 times daily is recommended as an adjunct to the usual warfarin therapy. Adjunct to Thallium Myocardial Perfusion Imaging Adults IV 0.142 mg/kg/min (0.57 mg/kg total) infused over 4 min is recommended. Total doses exceeding 60 mg are not needed for any patient.
Drug contraindicationshypersensitivity to drug or its components.
Side effectsnausea , Headache , chest pain , Tachycardia , abdominal pain , dizziness , vomiting , fatigue , Hepatic dysfunction , rash , flushing , Diarrhea , pruritus , hypotension , thrombocytopenia , palpitations , paresthesia , dyspepsia , edema , myalgia , Alopecia , malaise , Pain , abnormal ECG , Cholestasis , Angina pectoris
InteractionsAlteplase , Streptokinase , Enoxaparin , Protamine sulfat , Adenosine , Acetaminophen+caffeine , Acetaminophen+caffein+acetylsalic , Acetaminophan+caffeine+ibuprofen , Theophyline G , Topotecan , Galantamine , Neostigmine , Donepzil , Reteplase , Fludarabine phosphate , Dorzolamide and timolol , Bisoprolol , Physostigmine , Apixaban , Phenindione , Desirudin , Abciximab , Ginkgo biloba , Dalteparin , Tinzaparin , Tositumomab , Ibritumomab tiuxetan , icosapent , Betrixaban , Ramucirumab , Edoxaban , riociguat , Dasatinib , talazoparib , cangrelor , defibrotide , Nesiritide
1-Ensure that parenteral aminophylline and sublingual nitroglycerin are available before administering infusion. 2- Monitor vital signs and ECG during and for 10 to 15 min after infusion has been completed. 3- Be prepared to treat hypotension, bronchospasm, or ischemic chest pain.
Points of recommendation
1-Advise patient to take as prescribed without regard to meals but to take with food if stomach upset occurs 2-Caution patient that drug may cause dizziness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined 3-Advise patient to notify health care provider immediately if any of the following occur: rash or hives, difficulty breathing, persistent dizziness when arising from a sitting or lying position, fainting, yellowing of the skin or eyes.