Dipyridamole, 25 mg 100 pcs

Dipyridamole

Indications

Secondary prevention of ischemic stroke and transient ischemic attack (in combination with acetylsalicylic acid in low doses or as monotherapy for intolerance to acetylsalicylic acid); dyscirculatory encephalopathy; primary and secondary prevention of coronary artery disease, especially in case of intolerance to acetylsalicylic acid (for a dose of 75 mg); prevention of arterial and venous thrombosis and their complications; as an addition to indirect oral anticoagulants for the prevention of postoperative thromboembolic complications after heart valve replacement; prevention of placental insufficiency during complicated pregnancy; microcirculation disorders of any type (as part of complex therapy); as an interferon inducer and immunomodulator for the prevention and treatment of influenza, ARVI (for a dose of 25 mg).

Pharmacological effect

Pharmacotherapeutic group: Antithrombotic agents; antiplatelet agents, except heparin

Pharmacological action

Antiplatelet agent, angioprotector, immunomodulator. Has an inhibitory effect on platelet aggregation, improves microcirculation.

It has a vasodilating effect, reduces the resistance of resistive coronary vessels (mainly arterioles), and increases the volumetric velocity of coronary blood flow. Capable of reducing perfusion of ischemic areas of the myocardium.

The mechanism of action has not been fully elucidated. It is believed that dipyridamole increases the content of adenosine (impairing its reuptake), and also increases the concentration of cAMP due to inhibition of the PDE enzyme.

As a pyrimidine derivative, dipyridamole is an interferon inducer and has a modulating effect on the functional activity of the interferon system, increases the reduced production of interferon alpha and interferon gamma by blood leukocytes in vitro. Increases nonspecific resistance to viral infections.

Dipyridamole normalizes venous outflow and reduces the incidence of deep vein thrombosis in the postoperative period. Improves microcirculation in the retina and renal glomeruli.

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

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

Pharmacokinetics

After oral administration, dipyridamole is completely absorbed from the gastrointestinal tract. Cmax in blood plasma is reached after 75 minutes. Plasma protein binding is high.

T1/2 in the terminal phase is 10-12 hours.

Metabolized in the liver and excreted in bile mainly in the form of glucuronides. Elimination may be slowed due to enterohepatic recirculation. A small amount is excreted in the urine.

Special instructions

Use with caution in patients with arterial hypotension, recent myocardial infarction, or heart failure.

There is evidence that with intravenous administration of dipyridamole, uneven redistribution of blood flow in the coronary vessels and the development of steal syndrome, accompanied by aggravation of angina symptoms (including ST segment depression on the ECG), are possible. In this regard, patients regularly taking dipyridamole orally should not be given it additionally intravenously.

Active ingredient

Dipyridamole

Composition

Active substance: dipyridamole

Pregnancy

During pregnancy and breastfeeding, it should be used only after consultation with a doctor, in cases where the expected benefit to the mother outweighs the potential risk to the fetus or infant.

Contraindications

Hypersensitivity to dipyridamole; acute myocardial infarction; unstable angina; widespread stenotic atherosclerosis of the coronary arteries; subaortic stenosis; decompensated heart failure; severe arterial hypotension; severe arterial hypertension; severe heart rhythm disturbances; COPD; decompensated renal failure; liver failure; hemorrhagic diathesis; diseases with a tendency to bleeding (including peptic ulcer of the stomach and duodenum); children under 18 years of age (efficacy and safety have not been established).

With caution

Elderly patients (due to the risk of developing orthostatic hypotension).

Side Effects

From the digestive system: infrequently – nausea, vomiting, diarrhea.

From the cardiovascular system: infrequently – arterial hypotension, hot flashes, tachycardia (especially when taking vasodilators simultaneously); coronary steal syndrome (when used at a dose of more than 225 mg/day); frequency unknown – increased symptoms of coronary artery disease, such as angina pectoris, myocardial infarction.

From the digestive system: uncommon – nausea, vomiting, diarrhea, epigastric pain.

From the hematopoietic system: infrequently – thrombocytopenia, changes in the functional properties of platelets, bleeding; very rarely – increased bleeding after surgical interventions.

From the side of the central nervous system: frequency unknown – dizziness, headache.

Allergic reactions: skin rash, urticaria.

Other: frequency unknown – weakness, facial skin flushing, arthritis, myalgia, rhinitis.

Interaction

With the simultaneous use of drugs that reduce the acidity of the stomach contents (antacids, histamine H2 receptor blockers (including cimetidine), proton pump inhibitors (including omeprazole), the bioavailability of dipyridamole may decrease.

When used simultaneously with anticoagulants, acetylsalicylic acid, the antiplatelet effect of dipyridamole is enhanced.

When used simultaneously with anticholinergic drugs, memory and attention problems may occur in elderly patients.

When used simultaneously with beta-blockers, cases of bradycardia and asystole have been described when using dipyridamole in patients receiving beta-blockers.

When used simultaneously with adenosine, the effect of adenosine is enhanced.

When used simultaneously with dobutamine, there is a risk of developing severe arterial hypotension.

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

Dipyridamole enhances the effect of antihypertensive drugs.

Dipyridamole weakens the properties of cholinesterase inhibitors, which can lead to aggravation of myasthenia gravis.

Cephalosporins enhance the antithrombic effect of dipyridamole.

Manufacturer

Ozon, Russia