Dipyridamole - instructions for use, dose, side effects, contraindications

Composition:In 5 ml of the drug contains:
Active substance: dipyridamole 50 mg
Other Ingredients: magnesium aluminosilicate 12.5 mg, acid citric monohydrate (E330) 7.0 mg, polysorbate 80 5.0 mg, sodium
Hydrophosphate anhydrous (E339) 13.2 mg, ammonium glycyrrhizinate 5.0 mg emulsion simethicone 30% (Q7-2587) 2.5 mg, liquid maltitol (E965) 2.5 mg, propylene glycol (E1520) 125.0 mg, methyl ester (E218) 6.0 mg, propyl parahydroxybenzoate (E216) 1.5 mg, levomentol 0.75 mg, flavor Almond (F31209) (contains ethanol and propylene glycol) 10.0 mg, xanthan gum (E415) 17.5 mg, solution of sodium hydrophosphate anhydrous 5% qs, solution of acid citric monohydrate 5% qs; water purified to 5 ml.
Note: q.s. - the amount necessary to obtain a pH of 5.8 + 0.2.

Description:Suspension bright yellow color with a characteristic smell of almonds.

Pharmacotherapeutic group:Vasodilating agent.

ATX: & nbsp

B.01.A.C.07 Dipyridamole

Pharmacodynamics:Dipyridamole expands coronary vessels (mainly arterioles) and causes a significant increase in the volume flow rate. Increases the oxygen content in the venous blood of the coronary sinus and its absorption by the myocardium. Promotes the development of collateral coronary circulation, reduces the overall peripheral resistance of blood vessels, improves microcirculation, has an angioprotective effect. These effects are due to the increased activity of endogenous adenosine due to a decrease in its capture by tissues and destruction adenosine affects the smooth muscles of the vessels and prevents the release of norepinephrine. It is an antagonist of the endogenous adenosine diphosphate (ADP) aggregate, inhibits phosphodiesterase, thus reducing the release of platelet aggregation activators - thromboxane, ADP, serotonin, etc., increases prostaglandin PgI2 synthesis by endothelium of vascular tissue; which prevents the aggregation of platelets.Reduces adhezivnost platelets, prevents the formation of clots in the blood vessels and reduce blood flow in the source of ischemia. Antiaggregant effect occurs at a plasma concentration of 0.1 μg / ml dose-dependent lengthens the abnormally shortened life time of thrombocytes. Expands coronary arteries, especially unchanged, causes the phenomenon of stealing. It is an interferon inducer, has a modulating effect on the functional activity of the interferon system, increases the decreased production of interferon alpha and gamma by the leukocytes of blood in vitro. Increases nonspecific antiviral resistance to viral infections. Normalizes venous outflow, reduces the incidence of deep vein thrombosis in the postoperative period. Improves microcirculation in the retina of the eye, renal glomeruli. Reduces the tone of the cerebral vessels, it is effective for dynamic disorders of cerebral circulation.

Pharmacokinetics:After oral administration, it is quickly absorbed into the stomach (the larger part) and the small intestine. Bioavailability is 37-66%. The maximum concentration in the blood plasma is observed after 0.5-2 hours after taking the drug. Binding to plasma proteins by 80-95%.Quickly penetrates into the tissue. Accumulates in large quantities in the heart and red blood cells, is secreted with the breast
milk, about 6% of the concentration in the plasma. Metabolised in the liver with the formation of monoglyukuronide, which is excreted in bile (20% of the drug is included in enterohepatic circulation). The half-life is 9-12 hours. Cumulation is possible (mainly in patients with
impaired liver function).

Indications:- Treatment and prevention of cerebral circulation disorders by ischemic type, dyscirculatory encephalopathy;
- Prevention of arterial and venous thromboses and their complications, prophylaxis of thromboembolism after the operation of prosthetic valve of the heart;
- As part of complex therapy for any violations of microcirculation;
- As an inducer of interferon and immunomodulator for the prevention of influenza, acute respiratory viral infections (ARVI).

Contraindications:hypersensitivity to the components of the drug;
- intolerance to fructose;
- Acute myocardial infarction, unstable angina, widespread stenosing coronary artery atherosclerosis, hypertrophic obstructive cardiomyopathy;
Decompensated chronic heart failure;
- arterial hypotension, collapse;
- severe arterial hypertension;
- severe arrhythmias;
- hemorrhagic diathesis;
- diseases with a tendency to bleeding (peptic ulcer of stomach and duodenum, etc.);
- chronic obstructive pulmonary disease (COPD);
- Hepatic and / or renal insufficiency;
- age to 18 years.

Carefully:Blood clotting disorders.

Pregnancy and lactation:Dipyridamole can be prescribed during pregnancy and during breastfeeding only if the expected benefit of therapy for the mother exceeds the potential risk to the fetus and the baby. Dipyridamole is secreted into breast milk in an amount of about 6% of the concentration in the plasma, so during the period of breastfeeding it is prescribed only in cases of absolute necessity.

Dosing and Administration:Inside. Shake before use!
Take 1 hour before meals. Dosage regimen is set by the doctor individually depending on the severity of the disease and the patient's response to treatment.
To reduce the aggregation of platelets, it is recommended that dipyridamole in a dose of 300 mg / day in several doses (2 teaspoonfuls (100 mg) of a spoon 3 times a day).
In severe cases, the dose may be increased to 600 mg / day.
For the prevention of influenza and other acute respiratory viral infections, especially during epidemics, dipyridamole according to the following scheme: 50 mg (1 teaspoon) per day 1 time per 7 days for 4-5 weeks.
For the prevention of relapse, in patients with respiratory viral infections, who are often ill, dipyridamole it is recommended to take the following scheme: 100 mg (2 teaspoons) 2 times a day once a week for 8-10 weeks.

Side effects:When applying therapeutic doses, side effects are usually not expressed and are transient, usually disappear with a longer use of the drug. Side effects are listed below in descending frequency: often (1-10% of patients), infrequently (0.1-1% of patients), rarely (0.01-0.1% of patients), very rarely (less than 0.01% patients), including individual reports.
From the side of the heart and blood vessels: infrequent: palpitations, tachycardia, bradycardia, blood flushes to the face, coronary steal syndrome (when doses more than 225 mg / day), lowering blood pressure;
From the gastrointestinal tract: infrequently: nausea, vomiting, diarrhea, epigastric pain;
From the liver and bile ducts: frequency is unknown: dipyridamole may be included in gallstones;
From the side of the blood and lymphatic system: infrequently: thrombocytopenia, changes in the functional properties of platelets; rarely: bleeding; very rarely: increased
bleeding;
Other: weakness, dizziness, sensation of ear congestion, "noise in the ears," headache, flushing of the skin of the face, arthritis, myalgia, rhinitis, allergic reactions (skin rash, urticaria, severe bronchospasm, angioedema), in surgical interventions in rare cases increased bleeding during or after surgery.
If any of the side effects listed in the manual are aggravated, or if you notice any other side effects not listed in the instructions, tell your doctor.

Overdose:Symptoms: vasodilation, which is accompanied by a decrease in blood pressure, angina pectoris, tachycardia, weakness, dizziness, reddening of the face.
Treatment: Symptomatic therapy.
In case of an overdose, it is necessary to induce vomiting and to wash the stomach.The dilating effect of the drug can be treated with a slow intravenous injection of aminophylline (50-100 mg for 60 seconds).
With stenocardia, taking nitroglycerin under the tongue.
Due to the wide distribution in the tissues and predominantly the hepatic elimination of dipyridamole, the accelerated elimination procedures from the body probably will not be effective.

Interaction:Adenosine: dipyridamole increases the level of adenosine in the blood plasma and strengthens its cardiovascular effects. An adjustment of adenosine dosing is necessary.
Acetylsalicylic acid: effects of acetylsalicylic acid and dipyridamole, when combined, are summarized.
Antacid preparations: the use of antacids can lead to a decrease in the effectiveness of dipyridamole.
Anticoagulants: it is possible that dipyridamole can enhance the effects of anticoagulants. At simultaneous appointment with anticoagulants and acetylsalicylic acid it is necessary to estimate the information on intolerance and risks of these preparations. Addition of dipyridamole to acetylsalicylic acid does not increase the frequency of bleeding.With simultaneous administration with warfarin, the frequency and severity of bleeding was not higher compared with the use of one warfarin.
Dipyridamole can enhance the hypotensive effect of blood pressure lowering agents. Dipyridamole can weaken the anticholinergic properties of cholinesterase inhibitors.
Reception of xanthine derivatives (caffeine, theophylline) can lead to a decrease in the effectiveness of dipyridamole.
An antiaggregant effect is increased with the administration of antibiotics of the cephalosporin series (cefamandol, cefoperazone, cefotetan).

Special instructions:In patients with severe myasthenia gravis following the appointment of dipyridamole, dosage adjustments for the drugs used in complex therapy are necessary. Correction of the dose of cholinesterase inhibitors may be required after a change in the dose of dipyridamole.
Patients who receive dipyridamole orally, it is not possible to additionally administer it intravenously. If it is necessary to conduct a dipyridamole intravenous load test for the diagnosis of coronary artery disease, oral administration of the drug should be discontinued 24 hours before the procedure.Due to the presence of methyl- and propyl parahydroxybenzoate in the composition, the drug may cause delayed-type allergic reactions (for example, contact dermatitis) or (less often) immediate reaction (urticaria, bronchospasm).

Effect on the ability to drive transp. cf. and fur:In connection with the possible dizziness, weakness and a decrease in blood pressure during the period of taking dipyridamole, the ability to concentrate and speed of psychomotor reactions in patients can be reduced. Therefore, during the treatment with the drug, care should be taken when driving vehicles and engaging in potentially hazardous activities requiring increased concentration of attention and speed of psychomotor reactions.

Form release / dosage:Suspension for oral administration 50 mg / 5 ml.

Packaging:For 150 ml of the preparation into a bottle of orange glass type III, sealed with a screw cap of high-density polyethylene with an inner part of high-density polypropylene with a high-density polyethylene foam liner with a first opening ring and protection from children. 1 bottle with instructions for use in a cardboard box.

Storage conditions:Store at a temperature not exceeding 25 ° C.
Keep out of the reach of children.

Shelf life:2 years.
The drug should not be used after the expiry date indicated on the package.

Terms of leave from pharmacies:On prescription

Registration number:LP-000204

Date of registration:11.02.2011 / 04.07.2016

Expiration Date:Unlimited

The owner of the registration certificate:Rosemont Pharmaceuticals Ltd.Rosemont Pharmaceuticals Ltd. United Kingdom

Manufacturer: & nbsp

ROSEMONT PHARMACEUTICALS, Ltd. United Kingdom

Representation: & nbspSVYCH LLC SVYCH LLC Russia

Information update date: & nbsp2016-10-24

Illustrated instructions

Instructions

Dipyridamole (Dipiridamol)