Dipyridamole (Dipiridamol)

Composition Pharmacodynamics Indications Carefully Contraindications Dosing and Administration Side effects Form release / dosage
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Active substanceDipyridamoleDipyridamole
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    • Dosage form: & nbspTfilm-covered abeys.
    Composition:On one tablet:

    Dosage of 25 mg

    Active substance: dipyridamole 25.00 mg.

    Excipients: lactose monohydrate (sugar milk) - 32.10 mg, microcrystalline cellulose - 30.00 mg, croscarmellose sodium - 3.00 mg, copovidone - 4.00 mg, magnesium stearate - 0.90 mg.

    Shell composition: hypromellose - 1.24 mg, polysorbate-80 - 0.24 mg, dye quinoline yellow - 0.02 mg, titanium dioxide - 0.50 mg.

    Dosage of 75 mg

    Active substance: dipyridamole 75.00 mg.

    Excipients: lactose monohydrate (sugar milk) - 39.20 mg, microcrystalline cellulose - 60.00 mg, croscarmellose sodium - 6.00 mg, copovidone - 8.00 mg, magnesium stearate - 1.80 mg.

    Shell composition: hypromellose - 2.48 mg, polysorbate-80 - 0.48 mg, dye quinoline yellow - 0.04 mg, titanium dioxide - 1.00 mg.

    Description:TOrifle, biconvex tablets, covered with a film coating of yellow color; On the cross-section, two layers are visible: the core is from yellow to bright yellow and the film shell.

    Pharmacotherapeutic group:vasodilator
    ATX: & nbsp

    B.01.A.C.07   Dipyridamole

    Pharmacodynamics:

    Dipiridamole inhibits aggregation and adhesion of platelets, improves microcirculation, has a mild vasodilating effect.

    The mechanism by which dipyridamole has a retarding effect on platelet aggregation, is associated with inhibition of adenosine reuptake (platelet reactivity inhibitor) by endothelial cells, erythrocytes and platelets; activation of adenylate cyclase and inhibition of platelet phosphodiesterase. In this way, dipyridamole prevents the release of platelets aggregation activators - thromboxane (ТхА2), ADP, serotonin, and others. Dipyridamole increases the synthesis of prostacyclin PgI2 endothelium of the vascular wall, normalizes the ratio PgI2 and ТхА2, preventing the aggregation of platelets; enhances the synthesis of endothelial nitric oxide (N0). Dipyridamole reduces the adhesiveness of platelets, prevents the formation of blood clots in the vessels and stabilizes the blood flow in the source of ischemia.

    Dipiridamole dose-dependent extends the pathologically shortened life time of platelets.

    Dipiridamole, due to vasodilating properties, contributes to a reduction in overall peripheral vascular resistance, improves microcirculation, and has an angioprotective effect. These effects are due to the increased activity of endogenous adenosine (adenosine affects the smooth musculature of the vessels and prevents the release of norepinephrine). Dipyridamole has both angiogenic and arteriogenic activity, stimulating the formation of new capillaries and collateral arteries.

    Dipiridamole normalizes venous outflow, reduces the incidence of deep vein thrombosis in the postoperative period. Improves microcirculation in the retina of the eye and kidney glomeruli.

    In neurological practice, such pharmacodynamic effects of dipyridamole as a decrease in the tone of cerebral vessels and improvement of cerebral circulation are used.According to angiographic studies, the use of dipyridamole in combination with acetylsalicylic acid (ASA) is able to slow the progression of atherosclerosis.

    In obstetrical practice dipyridamole It is used to improve placental blood flow and prevent dystrophic changes in the placenta, eliminate fetal hypoxia and accumulate glycogen in them.
    Pharmacokinetics:

    Ingestion dipyridamole quickly absorbed from the gastrointestinal tract: most in the stomach and partially in the small intestine. Bioavailability is 37-66%, the time to reach the maximum concentration (TCmax) in the blood plasma for about 2 hours. Dipyridamole almost completely binds to blood plasma proteins.

    After oral administration, there is a two-phase character of a decrease in the concentration of dipyridamole in the blood plasma. The half-life of the drug in the initial phase is 20-30 minutes, and in the final phase of elimination is 10-12 hours. Dipyridamole metabolized in the liver by binding to glucuronic acid. Is allocated mainly in bile and is excreted through the intestine in the form of monoglucuronide.A small amount of dipyridamole (1-3%) is excreted by the kidneys.

    Indications:

    - Treatment and prevention of cerebral circulation disorders according to the ischemic type;

    - primary and secondary prevention of coronary heart disease (CHD), especially with intolerance to acetylsalicylic acid (ASA);

    - encephalopathy;

    - prevention of arterial and venous thrombosis and their complications;

    - prophylaxis of thromboembolism after surgery for prosthetic heart valves;

    - prevention of placental insufficiency in a complicated pregnancy;

    - in the complex therapy for disorders of microcirculation of any genesis;

    - as an inducer of interferon and immunomodulator for the prevention and treatment of influenza, ARVI.

    Contraindications:

    - Hypersensitivity to the components of the drug;

    - lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome;

    - acute myocardial infarction;

    - unstable angina;

    - common stenosing coronary artery atherosclerosis;

    - subaortic stenosis;

    - Decompensated heart failure;

    - severe arterial hypotension; collapse;

    - severe arterial hypertension;

    - severe heart rhythm disturbances;

    - chronic obstructive pulmonary disease (COPD);

    - decompensated kidney failure;

    - liver failure;

    - hemorrhagic diathesis;

    - diseases with a tendency to bleeding (peptic ulcer of the stomach and duodenum, etc.);

    - children under 12 years of age (efficacy and safety not studied).

    Carefully:With caution appoint elderly patients, can cause orthostatic hypotension.
    Pregnancy and lactation:

    The use of dipyridamole during pregnancy and during breastfeeding is possible only if the intended benefit to the mother exceeds the possible risk to the fetus and the baby. The duration of the course of treatment is determined by the doctor.

    Dosing and Administration:

    Tablets are taken orally, on an empty stomach, washed down with a small amount of water, without breaking and not cracking. The dose of the drug is selected depending on the indications, the severity of the disease and the patient's response to treatment. The duration of treatment is determined by the doctor.

    To reduce the aggregation of platelets it is recommended to take the drug in a daily dose of 75-225 mg.

    In severe cases, the daily dose can be increased to 600 mg.

    For the prevention of placental insufficiency it is recommended to take the drug Dipyridamole in a dose of 25 mg or 75 mg (1 tablet 3 times a day). The maximum recommended daily dose is 225 mg.

    For the prevention and treatment of cerebral circulation disorders The daily dose of dipyridamole is 225-450 mg (1 table 75 mg of the drug Dipiridamole 3-6 times a day).

    Patients with ischemic heart disease Drug administration is recommended. Dipyridamole 75 mg 3 times a day. If necessary, the dose may be increased under the supervision of a doctor.

    For the prevention of influenza and other ARVI, especially during epidemics, it is recommended to take the drug Dipyridamole according to the following scheme: 50 mg (2 tablets of 25 mg) every 7 days for 4-5 weeks.

    For the prevention of relapse in patients with respiratory viral infections, who are often ill, it is recommended to take the drug Dipyridamole according to the following scheme: 100 mg (2 tablets of 25 mg twice a day at intervals of 2 hours) once a week for 8-10 weeks.

    Dipyridamole is suitable for long-term treatment.

    Side effects:

    When the drug is used in therapeutic doses, side effects are usually not expressed and are transient.

    Possible side effects when using the drug are given below on the descending incidence frequency: often (> 1/100, <1/10), infrequently (> 1/1000, <1/100), rarely (> 1/10000, <1/1000 ), very rarely (<1/10000), including individual messages.

    From the side of the cardiovascular system:

    Infrequently: tachycardia, blood flushes to the face, lowering blood pressure (especially when combined with other vasodilators), coronary steal syndrome (when used at a dose of more than 225 mg / day).

    From the digestive system:

    Infrequently: nausea, vomiting, diarrhea, epigastric pain. Usually these side effects, appearing at the beginning of the course of treatment, disappear with a longer application of the drug.

    On the part of the blood and the system of homeostasis:

    Infrequently: thrombocytopenia, changes in the functional properties of platelets, bleeding.

    Rarely: increased bleeding after surgical interventions.

    From the immune system:

    Rarely: allergic reactions, such as skin rash, hives.

    Other: weakness, dizziness, headache, flushing of the face, arthritis, myalgia, rhinitis.

    Individual messages: increased symptoms of coronary heart disease (CHD), such as angina pectoris, myocardial infarction.

    Overdose:

    Symptoms: a marked decrease in blood pressure, the development or exacerbation of angina attacks, tachycardia, a feeling of heat, "tides" of blood to the face, increased sweating, anxiety, weakness and dizziness.

    Treatment: induction of vomiting, gastric lavage, the use of adsorbents to reduce absorption (Activated carbon etc.). The undesirable vasodilating effect of the drug can be suppressed with a slow (50-100 mg / min) intravenous injection of aminophylline. In case of symptoms of angina pectoris, sublingual application of nitroglycerin is indicated.

    Interaction:

    Xanthine derivatives (coffee, tea, theophylline derivatives) can weaken the vasodilating effect of dipyridamole.

    Dipyridamole, when used at the same time, can enhance the effect of anticoagulants and acetylsalicylic acid.

    Dipyridamole enhances the effect of antihypertensive drugs.

    Weaken the properties of cholinesterase inhibitors, which can lead to an aggravation of myasthenia flow gravis.

    Cephalosporins increase the antithrombotic effect of dipyridamole.

    Antacids reduce the maximum concentration of dipyridamole due to reduced absorption.

    Special instructions:

    The drug should not be given to children under 12 years of age.

    During treatment, you should avoid drinking coffee and tea.

    In patients with myasthenia gravis gravis after changing the dose of dipyridamole, you may need to adjust the dosage of the drugs used in the complex therapy of myasthenia gravis.

    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.

    With the syndrome of coronary stealing to improve intracardiac blood flow, the use of aminophylline is indicated.

    Effect on the ability to drive transp. cf. and fur:

    In connection with the possible reduction in blood pressure, the occurrence of dizziness during the period of taking the drug, the ability to concentrate and the speed of psychomotor reactions in patients may be reduced. Therefore, during treatment with dipyridamole, caution should be exercised when driving vehicles and engaging in potentially hazardous activities,requiring increased concentration of attention and speed of psychomotor reactions.

    Form release / dosage:

    Film coated tablets, 25 mg and 75 mg.

    Packaging:

    10, 25, 30, 50 tablets in a contour mesh box made of polyvinylchloride film and aluminum foil printed lacquered.

    10, 20, 30, 40, 50 or 100 tablets in cans of polyethylene terephthalate for medicinal products sealed with caps screwed with a first opening control or by a "push-turn" system of polypropylene or polyethylene, or polypropylene polymer cans for medicines, Corked with lids pulled with the control of the first opening of polyethylene.

    One jar or 1, 2, 3, 4, 5, 10 or 12 contour squares, together with the instruction for use, are placed in a cardboard package (bundle).

    Storage conditions:

    In the dark place at a temperature of no higher than 25 ° C.

    Keep out of the reach of children.

    Shelf life:

    3 years.

    Do not use after the expiration date.

    Terms of leave from pharmacies:On prescription
    Registration number:LP-003468
    Date of registration:26.02.2016
    Expiration Date:26.02.2021
    The owner of the registration certificate:ATOLL, LLC ATOLL, LLC Russia
    Manufacturer: & nbsp
    Representation: & nbspOZONE LLC OZONE LLC Russia
    Information update date: & nbsp26.07.2016
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