Dipyridamole / Aspirin
Pronouncation: (dye-peer-ID-a-mole/ASS-pihr-in)Class: Antiplatelet combination agent
Trade Names:
Aggrenox
- Capsules 200 mg dipyridamole, extended-release/25 mg aspirin
Pharmacology
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Antithrombotic action resulting from additive antiplatelet effects.
Indications and Usage
Reduce the risk of stroke in patients who have had transient ischemia of the brain or complete ischemic stroke caused by thrombosis.
Contraindications
Hypersensitivity to dipyridamole, aspirin, or other components of product; allergy to NSAIDs; patients with asthma, rhinitis, and nasal polyps; children or teenagers with viral infections, with or without fever (Reye syndrome).
Dosage and Administration
AdultsPO 1 capsule (200 mg extended-release dipyridamole/25 mg aspirin) twice daily, 1 in morning and 1 in evening with a full glass of water. Do not crush or chew.
Storage/Stability
Store at controlled room temperature. Protect from excessive moisture.
Drug Interactions
AdenosineMetabolism of adenosine may be inhibited by dipyridamole, producing profound bradycardia.
Cholinesterase inhibitors (eg, tacrine)Dipyridamole may counteract anticholinesterase effect, potentially aggravating myasthenia gravis.
ACE inhibitors (eg, captopril), beta blockers (eg, propranolol), diuretics (eg, furosemide), uricosuric agents (eg, probenecid)The effects of these agents may be decreased by aspirin.
Acetazolamide, anticoagulants (eg, warfarin), anticonvulsants (eg, valproic acid), methotrexate, NSAIDs (eg, ibuprofen), oral hypoglycemic agents (eg, chlorpropamide)The pharmacologic and toxic effects of these agents may be increased by aspirin.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Cardiac failure; arrhythmia; supraventricular tachycardia.
CNS
Headache; amnesia; convulsions; anorexia; somnolence; confusion; coma; cerebral, subarachnoid, and intracranial hemorrhage.
Dermatologic
Stevens-Johnson syndrome.
GI
Abdominal pain; dyspepsia; nausea; vomiting; diarrhea; melena; rectal hemorrhage; GI hemorrhage; hemorrhoids; perforation; Reye syndrome.
Hematologic
Hemorrhage; epistaxis; anemia; purpura.
Hepatic
Hepatic failure.
Respiratory
Coughing; upper respiratory infection.
Miscellaneous
Arthralgia; arthritis; myalgia; arthrosis; pain; fatigue; back pain; asthenia; neoplasm; malaise; syncope; anaphylaxis; laryngeal edema; rhabdomyolysis.
Precautions
MonitorMonitor patient for signs and symptoms of cerebral ischemia. |
Pregnancy
Category D (aspirin); Category B (dipyridamole).
Lactation
Excreted in breast milk.
Children
Safety and efficacy not established.
Renal Function
Avoid in patients with severe renal failure (ie, glomerular filtration rate less than 10 mL/min).
Alcohol
Concurrent consumption of alcohol may increase risk of bleeding.
Coagulation
Platelet function may be inhibited, increasing the risk of bleeding.
Coronary artery disease
Use with caution.
Hypotension
Use with caution.
Overdosage
Symptoms
Dipyridamole: warm feeling, flushes, sweating, restlessness, weakness, dizziness, hypotension, tachycardia. Aspirin: tinnitus, nausea, vomiting, dizziness, respiratory alkalosis, metabolic acidosis, hemorrhage, convulsions. Significant overdose (4 to 10 g aspirin) is a medical emergency.
Patient Information
- Advise patient to not crush or chew medication and to swallow the capsule whole with a full glass of water two times a day.
- Advise patient regarding risks of drinking alcohol while taking this medication.
- Advise patient to report any of the following to their health care provider immediately: recurrent signs or symptoms of cerebral ischemia, unusual bleeding, rash, hives, or difficulty breathing.
- Advise patients to inform their health care provider if they experience bothersome side effects such as headache, indigestion, stomach pain, nausea, dizziness, or excessive bruising while taking this medication.
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Ischemic Stroke -- Prophylaxis
