Dipyridamol-FPO, 25 mg 120 pcs

Pharmacotherapeutic group Vasodilator

ATC code B01AC07

Pharmacodynamics
.
Dipyridamole inhibits platelet aggregation and adhesion, improves microcirculation, and has a mild vasodilator effect. The mechanism by which dipyridamole has an inhibitory effect on platelet aggregation is related to the inhibition of adenosine reuptake (platelet reactivity inhibitor) by endothelial cells, red blood cells and platelets; activation of adenylate cyclase and inhibition of platelet phosphodiesterase. Thus, dipyridamole prevents the release of aggregation activators from platelets – thromboxane (TxA2), ADP, serotonin and others. Dipyridamole increases the synthesis of prostacyclin PgI2 by vascular endothelium, normalizes the ratio of PgI2 and TxA2 and prevents platelet aggregation, increases the synthesis of endothelial nitric oxide (NO).

Dipyridamole reduces platelet adhesiveness, prevents the formation of thrombi in vessels and stabilizes blood flow in ischemic areas.

Dipyridamole, due to its vasodilative properties, helps to reduce the overall peripheral resistance of vessels, improves microcirculation and has an angioprotective effect. These effects are due to increased activity of endogenous adenosine (adenosine affects vascular smooth muscle and prevents release of norepinephrine). Dipyridamole has both angiogenic and arteriogenic activity, stimulating the formation of new capillaries and collateral arteries.

Dipyridamole normalizes venous outflow, reduces the frequency of deep vein thrombosis in the postoperative period. It improves microcirculation in the retina and renal glomeruli.

In neurological practice such pharmacodynamic effects of dipyridamole as reduction of tone of cerebral vessels and improvement of cerebral circulation are used. According to angiographic studies, the use of dipyridamole in combination with acetylsalicylic acid can slow the progression of atherosclerosis.

In obstetrical practice dipyridamole is used to improve placental blood flow and prevent dystrophic changes in the placenta, eliminating hypoxia of fetal tissue and glycogen accumulation in them.

Pharmacokinetics

Absorption

Dipyridamole is rapidly absorbed from the gastrointestinal tract when ingested: Most in the stomach and partly in the small intestine. Bioavailability is 37-66%, time to reach maximum concentration in blood plasma is about 2 hours.

Distribution

Dipyridamole is almost completely bound to blood plasma proteins. After oral administration there is a biphasic pattern of decrease in blood plasma concentration of dipyridamole.

Metabolism

Dipyridamole is metabolized in the liver by binding to glucuronic acid.

Elimation

The half-life in the initial phase is 20-30 minutes, and in the final phase of excretion – 10-12 hours. It is excreted mainly in bile and excreted through the intestine as monoglucuronide. A small amount of dipyridamole (1-3 %) is excreted by the kidneys.

Indications

Active ingredient

Composition

How to take, the dosage

Interaction

Directions for use

Unless otherwise prescribed by the physician, the following dosing regimens are recommended:

Dipyridimol at a dose of 75-225 mg/day in multiple doses is recommended to reduce platelet aggregation. In severe cases, the dose may be increased to 600 mg/day.

. For prophylaxis of thromboembolic syndrome, stent thrombosis and aortocoronal shunts, 50 mg along with ASA on the first day, then 100 mg, 4 times a day (withdraw 7 days after surgery if ASA is continued at a dose of 325 mg/day) or 100 mg 4 times a day for 2 days before surgery and 100 mg 1 hour after surgery (in combination with warfarin, if necessary).

For prevention of influenza and other acute respiratory diseases, especially during epidemics, take the following regimen: 50 mg/day once every 7 days for 4-5 weeks.

To prevent relapses, in patients with frequent respiratory viral infections, Dipyridamole is recommended to be taken according to the scheme: 100 mg/day (2 times 50 mg, 2 hours apart) once a week for 8 to 10 weeks.

Dipyridamole is recommended to be taken on an empty stomach, without chewing the coated tablets, with a small amount of liquid.

Special Instructions

Synopsis

Contraindications

Side effects

Classification of the frequency of side effects according to the World Health Organization (WHO) recommendations: very common (≥ 1/10); common (≥ 1/100 to < 1/10); infrequent (≥ 1/1000 to < 1/100); rare (≥ 1/10000 to < 1/1000); very rare (< 1/10000, including individual reports; frequency is unknown – according to available data it is impossible to determine the frequency of occurrence.

Cardiac disorders:

infrequent – tachycardia, “flushes” of blood to the face, coronary bypass syndrome (when used at a dose greater than 225 mg/day).

Vascular disorders:

infrequent – decreased blood pressure (especially when combined with other vasodilators).

Gastrointestinal tract disorders:

infrequent – nausea, vomiting, diarrhea, epigastric pain.

Usually these side effects, which appear at the beginning of treatment, disappear with longer use of the drug.

Blood and homeostasis disorders:

infrequent – thrombocytopenia, change of platelet functional properties, bleeding;

very rare – increased bleeding after surgical interventions.

The immune system:

rarely – allergic reactions such as skin rash, urticaria.

Other:

frequency unknown – weakness, dizziness, headache, facial skin hyperemia, arthritis, myalgia, rhinitis, increased symptoms of CHD, such as angina, myocardial infarction.

Overdose

Pregnancy use

Similarities