Dipyridamol-FPO, 75 mg 40 pcs

Pharmacotherapeutic group: Vasodilator

ATX 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 phosphodiesterases. Thus, dipyridamole prevents the release of aggregation activators from platelets – thromboxane (TxA2), ADP, serotonin and others. Dipyridamole increases synthesis of prostacyclin PgI2 by vascular endothelium, normalizes ratio of PgI2 and TxA2, preventing platelet aggregation and increases synthesis of endothelial nitric oxide (NO).

Dipyridamole reduces platelet adhesiveness, prevents clot formation in vessels and stabilizes blood flow in the focus of ischemia.

Dipyridamole dose-dependently prolongs abnormally shortened platelet lifespan.

Dipyridamole due to its vasodilatory properties helps to decrease total peripheral resistance of blood vessels, improves microcirculation and has 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 incidence 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 cerebral vascular tone 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 to prevent dystrophic changes in the placenta, to eliminate hypoxia of fetal tissues and accumulation of glycogen in them.

Pharmacokinetics

Absorption

. When taken orally, dipyridamole is rapidly absorbed from the gastrointestinal tract: Most in the stomach and partly in the small intestine. Bioavailability is 37-66%, the time of reaching maximum concentration in blood plasma is about 2 hours.

Distribution

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

Metabolism

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

Elimation

The elimination half-life is 20-30 minutes in the initial phase and 10-12 hours in the final phase of elimination. It is excreted mainly in the bile and is 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

Xanthine derivatives (coffee, tea, theophylline derivatives) may weaken the vasodilator effect of dipyridamole.

Dipyridamole may increase the effect of anticoagulants and acetylsalicylic acid when used simultaneously.

Dipyridamole increases the effect of hypotensive drugs.

Dipyridamole weakens cholinesterase inhibitors, which may worsen the course of myasthenia gravis.

The cephalosporins increase the antithrombic effect of dipyridamole.

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

Special Instructions

Synopsis

Contraindications

Side effects

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

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:

infrequent – nausea, vomiting, diarrhea, epigastric pain.

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

Blood and homeostasis system:

infrequent – thrombocytopenia, changes in the functional properties of platelets, bleeding;

very rare – increased bleeding after surgical interventions.

An immune system side:

rarely – allergic reactions such as skin rash, urticaria.

Others:

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

Overdose

Pregnancy use

Similarities