di·pyr·id·a·mole (d -p r -d -m l , -p-rd-)n. A drug that acts as a coronary vasodilator and is used in the long-term treatment of angina pectoris. |
dipyridamole
dipyridamole [di″pi-rid´ah-mōl]
dipyridamole
mol´), n brand name: Persantine;
drug class: platelet aggregation inhibitor;
action: specific action unclear; inhibits ability of platelets to aggregate;
uses: prevention of transient ischemic attacks (TIA), inhibition of platelet aggregation to prevent myocardial reinfarction, prevention of coronary bypass graft occlusion with aspirin.
dipyridamole
Apo-Dipyridamole FC (CA), Apo-Dipyridamole SC (CA), Novo-Dipiradol (CA), Persantin (UK), Persantine
Pharmacologic class: Platelet adhesion inhibitor
Therapeutic class: Antiplatelet agent, diagnostic agent (coronary vasodilator)
Pregnancy risk category B
Action
Unclear. May reduce platelet aggregation by inhibiting phosphodiesterase, adenosine uptake, or formation of thromboxane A2. Produces vasodilation, thereby increasing coronary blood flow.
Availability
Injection: 10 mg/2 ml
Tablets: 25 mg, 50 mg, 75 mg, 100 mg
⊘Indications and dosages
➣ To prevent thromboembolism in patients with prosthetic heart valves
Adults: 75 to 100 mg P.O. q.i.d.
➣ Alternative to exercise in thallium myocardial perfusion imaging
Adults: 0.57 mg/kg I.V. infused over 4 minutes (0.142 mg/kg/minute). Maximum I.V. dosage is 60 mg.
Off-label uses
• Prevention of myocardial reinfarction (given with aspirin)
• Thrombotic thrombocytopenia purpura
Contraindications
• Hypersensitivity to drug
Precautions
Use cautiously in:
• hypotension, platelet defects
• pregnant or breastfeeding patients (safety not established)
• children younger than age 12 (safety not established).
Administration
• Know that drug is usually given with warfarin when used to prevent thromboembolism.
• Dilute I.V. solution with dextrose 5% in water or normal or half-normal saline solution, as directed.
• Give single I.V. dose over 4 minutes.
• When used as diagnostic agent, administer within 5 minutes of thallium injection.
• Give oral form with a full glass of water at least 1 hour before or 2 hours after meals. If gastric distress occurs, give with food.
| Route | Onset | Peak | Duration |
| P.O. | Unknown | Unknown | Unknown |
| I.V. | Unknown | 6.5 min | 30 min |
Adverse reactions
CNS: dizziness, headache, syncope; transient cerebral ischemia or weakness (with I.V. use)
CV: hypotension, arrhythmias, myocardial infarction (all with I.V. use)
GI: nausea, vomiting diarrhea, dyspepsia
Hematologic: prolonged bleeding time
Respiratory: bronchospasm (with I.V. use)
Skin: rash, flushing (with I.V. use)
Interactions
Drug-drug. Anticoagulants, cefamandole, cefoperazone, cefotetan, nonsteroidal anti-inflammatory drugs, plicamycin, sulfinpyrazone, thrombolytics, valproic acid: increased risk of bleeding
Aspirin: increased effect on platelet aggregation
Theophylline: negation of dipyridamole effects during thallium imaging
Drug-behaviors. Alcohol use: increased risk of hypotension
Patient monitoring
• Monitor for therapeutic efficacy, including improved exercise tolerance and decreased need for nitrates.
• Assess platelet and coagulation studies regularly.
• Monitor ECG and vital signs, especially blood pressure.
Patient teaching
• Advise patient to take drug 1 hour before or 2 hours after meals for best absorption.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.
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