Trade Names:Persantine- Tablets 25 mg- Tablets 50 mg- Tablets 75 mg
Trade Names:Dipyridamole- Injection 5 mg/mLApo-Dipyridamole-FC (Canada)
Lengthens abnormally shortened platelet survival time in a dose-dependent manner by inhibiting platelet aggregation in response to various stimuli, such as platelet activating factor, collagen, and adenosine diphosphate. Vasodilation may result from inhibition of adenosine uptake, which is an important mediator of coronary vasodilation.
Two minutes after a 4 min IV infusion, the mean serum level is 4.6 mcg/mL.
Highly bound to plasma protein (99%). Vd is 1 to 2.5 L/kg.
Metabolized in the liver (conjugated as a glucuronide).
Excreted in the bile. Average total body Cl is 2.3 to 3.5 mL/min/kg. The alpha t ½ (initial decline following C max ) is about 40 min, while the beta t ½ (terminal decline in plasma level) is approximately 10 h (oral). Triexponential: the t ½ range is 3 to 13 min, 33 to 62 min, and 11.6 h (IV).
The average time to C max is about 75 min.
Adjunct to coumarin anticoagulants in prevention of postoperative thromboembolic complication of cardiac valve replacement (oral). Alternative to exercise in thallium myocardial perfusion imaging for evaluating coronary artery disease in patients who cannot exercise adequately (IV).
PO 75 to 100 mg 4 times daily is recommended as an adjunct to the usual warfarin therapy.Adjunct to Thallium Myocardial Perfusion ImagingAdults
IV 0.142 mg/kg/min (0.57 mg/kg total) infused over 4 min is recommended. Total doses exceeding 60 mg are not needed for any patient.
Store tablets at controlled room temperature (59° to 86°F). Store injection at controlled room temperature (59° to 77°F). Protect from light and freezing.
Plasma levels of adenosine may be elevated, increasing the CV effects.Cholinesterase inhibitors
Anticholinesterase effects may be counteracted by dipyridamole, potentially aggravating myasthenia gravis.Theophyllines, xanthine derivatives (eg, caffeine)
May abolish coronary vasodilation induced by IV dipyridamole.
None well documented.
Oral Angina pectoris; hypotension, palpitation, tachycardia (postmarketing).
IV Chest pain, angina pectoris (20%).
Oral Dizziness (14%); headache (2%); fatigue, malaise, (postmarketing).
IV Headache, dizziness (12%); paresthesia, fatigue (1%).
Oral Rash (2%); pruritus; alopecia (postmarketing).
Oral Larynx edema (postmarketing).
Oral Abdominal distress (6%); diarrhea; vomiting; nausea, dyspepsia (postmarketing).
IV Nausea (5%); dyspepsia (1%).
Oral Hepatic failure; elevated liver enzymes; hepatitis, cholelithiasis (postmarketing).
IV ECG abnormalities/ST-T changes (8%); ECG abnormalities/extrasystoles, hypotension (5%); ECG abnormalities/tachycardia (3%); BP lability, hypertension (2%).
Oral Myalgia (postmarketing).
IV Dyspnea (3%).
Oral Flushing; hypersensitivity (including rash, urticaria, severe bronchospasm, angioedema), arthritis, paresthesia (postmarketing).
IV Flushing, unspecific pain (3%).
Ensure that parenteral aminophylline and sublingual nitroglycerin are available before administering infusion. Monitor vital signs and ECG during and for 10 to 15 min after infusion has been completed. Be prepared to treat hypotension, bronchospasm, or ischemic chest pain.
Category B .
Excreted in breast milk.
Safety and efficacy not established in children under 12 yr of age (oral).
Safety and efficacy not established (IV).
Because dipyridamole has a vasodilatory effect, use with caution in patients with severe coronary artery disease.
Because dipyridamole can produce peripheral vasodilation, use with caution in patients with hypotension.
Administration of IV dipyridamole has been associated with cardiac death, fatal and nonfatal MI, ventricular fibrillation, symptomatic ventricular tachycardia, stroke, transient cerebral ischemia, seizures, anaphylactoid reaction, and bronchospasm.
Warm feeling, flushes, sweating, restlessness, feeling of weakness, dizziness.
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