Dipyridamole
- Atc Codes:B01AC07
- CAS Codes:58-32-2
- PHARMGKB ID:58-32-2
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Belgium: Coronair, Dipyridamole EG, Persantine; Bulgaria: Antistenocardin, Biocardin; Cyprus: Perazodin, Persantin, Procardin; Denmark: Persantin; Finland: Dipyrin, Persantin; France: Cleridium, Persantine; Greece: Adezan, Persantin; Ireland: Persantin; Italy: Corosan, Persantin; Luxembourg: Dipyridamol, Persantine; Malta: Dipyridamole, Perazodin; Netherlands: Dipyridamol, Persantin, Persantine; Poland: Curantyl, Persantin; Portugal: Dipiridamol, Persantin; Romania: Dipiridamol; Spain: Persantin; Sweden: Persantin; UK: Dipyridamole, Persantin.
North America
Canada: Dipyridamole, Persantine; USA: Dipyridamole, Persantine.
Latin America
Argentina: Dipiridamol, Maxicardil, Persantin; Brazil: Persantin; Mexico: Digal, Dipres, Dirinol, Lodimol, Persantin, Pracem, Trepol, Vadinar.
Asia
Japan: Agilease, Anginal, Calcora, Coronamole, Dipyramole, Dipyridamole, Gulliostin, Healthside, Herzdol, Lucus, Metropolyn, Nichiridamol, Pamzen, Penselin, Percystan, Permiltin, Persantin, Piroan, Sanpell, Shiphnos, Tohmol, Youridamole.
Drug combinations
Dipyridamole and Aspirin
Chemistry
Dipyridamole: C~24~H~40~N~8~O~4~. Mw: 504.63. (1) Ethanol, 2,2′,2»,2»’-[(4,8-di-1-piperidinylpyrimido[5,4-d]pyrimidine-2,6-diyl)dinitrilo]tetrakis-; (2) 2,2′,2»,2»-[(4,8-Dipiperidinopyrimido[5,4-d]pyrimidine-2,6-diyl)dinitrilo]tetraethanol. CAS-58-32-2 (1963).
Pharmacologic Category
Antithrombotic Agents; Platelet-aggregation Inhibitors. Vasodilating Agents, Miscellaneous. (ATC-Code: B01AC07).
Mechanism of action
Dipyridamole is a non-nitrate coronary vasodilator which inhibits the activity of adenosine deaminase and phosphodiesterase, which causes an accumulation of adenosine, adenine nucleotides, and cAMP. These mediators inhibit platelet aggregation and may cause vasodilation. May stimulate release of prostacyclin or PGD~2~. Causes coronary vasodilation.
Therapeutic use
Dipyridamole is used orally as an adjunct to coumarin anticoagulants (warfarin) in the prevention of postoperative thromboembolic complications of heart valve replacement. Extended-release dipyridamole in fixed combination with aspirin is used to reduce the risk of stroke in patients who have had transient ischemic attacks or completed thrombotic stroke (secondary prevention). Also used I.V. as an adjunct to thallous (thallium) chloride ^201^Tl myocardial stress perfusion imaging in patients unable to exercise adequately.
Pregnancy and lactiation implications
There are no adequate, controlled studies to date using dipyridamole in pregnant women, and the drug should be used during pregnancy only when clearly needed. Extended-release dipyridamole in fixed combination with aspirin should be avoided in the 3^rd^ trimester of pregnancy and during labor and delivery because of the aspirin component of this preparation. Should be used with caution in nursing women.
Unlabeled use
Contraindications
Hypersensitivity to dipyridamole or any component of the formulation. Hypersensitivity to aspirin if used in fixed combination with dipyridamole.
Warnings and precautions
Caution in hypotension, or severe coronary artery disease (unstable angina, recent myocardial infarction) due to risk of peripheral vasodilation. Anaphylactoid reactions and bronchospasm reported with I.V. administration. Patients with history of asthma may be at greater risk for bronchospasm. Use with caution in hepatic impairment (elevations of hepatic enzymes, hepatic failure reported), and in patients on other antiplatelet agents or anticoagulation.