Dipyridamole (tablet): Difference between revisions
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* Adverse reactions at therapeutic doses are usually minimal and transient. On long-term use of dipyridamole USP tablets initial side effects usually disappear. The following reactions in Table 1 were reported in two heart valve replacement trials comparing dipyridamole USP tablets and warfarin therapy to either warfarin alone or warfarin and placebo: | |||
: [[File:{{PAGENAME}}02.png|thumb|none|600px|This image is provided by the National Library of Medicine.]] | |||
* Other reactions from uncontrolled studies include diarrhea, vomiting, flushing and pruritus. In addition, angina pectoris has been reported rarely and there have been rare reports of liver dysfunction. On those uncommon occasions when adverse reactions have been persistent or intolerable, they have ceased on withdrawal of the medication. | |||
* When dipyridamole USP tablets were administered concomitantly with warfarin, bleeding was no greater in frequency or severity than that observed when warfarin was administered alone. In rare cases, increased bleeding during or after surgery has been observed. In post-marketing reporting experience, there have been rare reports of hypersensitivity reactions (such as rash, urticaria, severe bronchospasm, and angioedema), larynx edema, fatigue, malaise, myalgia, arthritis, nausea, dyspepsia, paresthesia, hepatitis, thrombocytopenia, alopecia, cholelithiasis, hypotension, palpitation, and tachycardia. | |||
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There is limited information regarding <i>Postmarketing Experience</i> of {{PAGENAME}} in the drug label. | There is limited information regarding <i>Postmarketing Experience</i> of {{PAGENAME}} in the drug label. | ||
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Revision as of 22:52, 13 July 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gerald Chi
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Overview
Dipyridamole (tablet) is a platelet aggregation inhibitor that is FDA approved for the {{{indicationType}}} of postoperative thromboembolic complications of cardiac valve replacement. Common adverse reactions include chest pain, electrocardiogram abnormalities, flushing, rash, abdominal discomfort, dizziness, headache, and dyspnea.
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
Adjunctive Use in Prophylaxis of Thromboembolism after Cardiac Valve Replacement
- Dosing Information
- The recommended dose is 75-100 mg four times daily as an adjunct to the usual warfarin therapy.
- Please note that aspirin is not to be administered concomitantly with coumarin anticoagulants.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
Prophylaxis of Cerebrovascular Accident
- Developed by: ACCP
- Class of Recommendation: Class IIb
- Strength of Evidence: Category B
- Dosing Information
Non–Guideline-Supported Use
Peripheral Arterial Occlusive Disease
- Dosing Information
- 75 mg daily and aspirin 330 mg daily for 2 years[3]
Prophylaxis of Vascular Graft Occlusion
- Dosing Information
- 100 mg 4 times per day before the operation followed by DIPYRIDAMOLE 75 mg 3 times per day plus ASPIRIN 325 mg 3 times per day after the operation[4]
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
- Safety and effectiveness in the pediatric population below the age of 12 years have not been established.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Dipyridamole (tablet) in pediatric patients.
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Dipyridamole (tablet) in pediatric patients.
Contraindications
- Hypersensitivity to dipyridamole and any of the other components.
Warnings
Precautions
- General
- Coronary Artery Disease: Dipyridamole has a vasodilatory effect and should be used with caution in patients with severe coronary artery disease (e.g., unstable angina or recently sustained myocardial infarction). Chest pain may be aggravated in patients with underlying coronary artery disease who are receiving dipyridamole.
- Hepatic Insufficiency: Elevations of hepatic enzymes and hepatic failure have been reported in association with dipyridamole administration.
- Hypotension: Dipyridamole should be used with caution in patients with hypotension since it can produce peripheral vasodilation.
- Laboratory Tests
- Dipyridamole has been associated with elevated hepatic enzymes.
Adverse Reactions
Clinical Trials Experience
- Adverse reactions at therapeutic doses are usually minimal and transient. On long-term use of dipyridamole USP tablets initial side effects usually disappear. The following reactions in Table 1 were reported in two heart valve replacement trials comparing dipyridamole USP tablets and warfarin therapy to either warfarin alone or warfarin and placebo:
- Other reactions from uncontrolled studies include diarrhea, vomiting, flushing and pruritus. In addition, angina pectoris has been reported rarely and there have been rare reports of liver dysfunction. On those uncommon occasions when adverse reactions have been persistent or intolerable, they have ceased on withdrawal of the medication.
- When dipyridamole USP tablets were administered concomitantly with warfarin, bleeding was no greater in frequency or severity than that observed when warfarin was administered alone. In rare cases, increased bleeding during or after surgery has been observed. In post-marketing reporting experience, there have been rare reports of hypersensitivity reactions (such as rash, urticaria, severe bronchospasm, and angioedema), larynx edema, fatigue, malaise, myalgia, arthritis, nausea, dyspepsia, paresthesia, hepatitis, thrombocytopenia, alopecia, cholelithiasis, hypotension, palpitation, and tachycardia.
Postmarketing Experience
There is limited information regarding Postmarketing Experience of Dipyridamole (tablet) in the drug label.
Drug Interactions
- Drug
- Description
Use in Specific Populations
Pregnancy
- Pregnancy Category
- Australian Drug Evaluation Committee (ADEC) Pregnancy Category
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Dipyridamole (tablet) in women who are pregnant.
Labor and Delivery
There is no FDA guidance on use of Dipyridamole (tablet) during labor and delivery.
Nursing Mothers
There is no FDA guidance on the use of Dipyridamole (tablet) with respect to nursing mothers.
Pediatric Use
There is no FDA guidance on the use of Dipyridamole (tablet) with respect to pediatric patients.
Geriatic Use
There is no FDA guidance on the use of Dipyridamole (tablet) with respect to geriatric patients.
Gender
There is no FDA guidance on the use of Dipyridamole (tablet) with respect to specific gender populations.
Race
There is no FDA guidance on the use of Dipyridamole (tablet) with respect to specific racial populations.
Renal Impairment
There is no FDA guidance on the use of Dipyridamole (tablet) in patients with renal impairment.
Hepatic Impairment
There is no FDA guidance on the use of Dipyridamole (tablet) in patients with hepatic impairment.
Females of Reproductive Potential and Males
There is no FDA guidance on the use of Dipyridamole (tablet) in women of reproductive potentials and males.
Immunocompromised Patients
There is no FDA guidance one the use of Dipyridamole (tablet) in patients who are immunocompromised.
Administration and Monitoring
Administration
- Oral
- Intravenous
Monitoring
There is limited information regarding Monitoring of Dipyridamole (tablet) in the drug label.
Condition1
- Description
IV Compatibility
There is limited information regarding IV Compatibility of Dipyridamole (tablet) in the drug label.
Overdosage
Acute Overdose
Signs and Symptoms
- Description
Management
- Description
Chronic Overdose
There is limited information regarding Chronic Overdose of Dipyridamole (tablet) in the drug label.
Pharmacology
Dipyridamole (tablet)
| |
Systematic (IUPAC) name | |
2,2',2'',2'''-(4,8-di(piperidin-1-yl)pyrimido[5,4-d]pyrimidine-2,6-diyl)bis(azanetriyl)tetraethanol | |
Identifiers | |
CAS number | |
ATC code | B01 |
PubChem | |
DrugBank | |
Chemical data | |
Formula | Template:OrganicBox atomTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox |
Mol. mass | 504.626 g/mol |
SMILES | & |
Pharmacokinetic data | |
Bioavailability | ? |
Protein binding | 99% |
Metabolism | Hepatic |
Half life | Alpha (40 mins), Beta (10 Hours) |
Excretion | ? |
Therapeutic considerations | |
Pregnancy cat. |
B |
Legal status |
POM(UK) [[Prescription drug|Template:Unicode-only]](US) |
Routes | oral, IV |
Mechanism of Action
Structure
Pharmacodynamics
There is limited information regarding Pharmacodynamics of Dipyridamole (tablet) in the drug label.
Pharmacokinetics
There is limited information regarding Pharmacokinetics of Dipyridamole (tablet) in the drug label.
Nonclinical Toxicology
There is limited information regarding Nonclinical Toxicology of Dipyridamole (tablet) in the drug label.
Clinical Studies
There is limited information regarding Clinical Studies of Dipyridamole (tablet) in the drug label.
Condition1
- Description
How Supplied
Storage
There is limited information regarding Dipyridamole (tablet) Storage in the drug label.
Images
Drug Images
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Package and Label Display Panel
{{#ask: Label Page::Dipyridamole (tablet) |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}
Patient Counseling Information
There is limited information regarding Patient Counseling Information of Dipyridamole (tablet) in the drug label.
Precautions with Alcohol
- Alcohol-Dipyridamole (tablet) interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Brand Names
- Persantine®[5]
Look-Alike Drug Names
- A® — B®[6]
Drug Shortage Status
Price
References
The contents of this FDA label are provided by the National Library of Medicine.
- ↑ Diener, H. C. (2001-04). "Cardiac safety in the European Stroke Prevention Study 2 (ESPS2)". International Journal of Clinical Practice. 55 (3): 162–163. ISSN 1368-5031. PMID 11351768. Unknown parameter
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ignored (help); Check date values in:|date=
(help) - ↑ Diener, H. C. (1998-09). "Dipyridamole trials in stroke prevention". Neurology. 51 (3 Suppl 3): –17-19. ISSN 0028-3878. PMID 9744826. Check date values in:
|date=
(help) - ↑ Hess, H. (1985-02-23). "Drug-induced inhibition of platelet function delays progression of peripheral occlusive arterial disease. A prospective double-blind arteriographically controlled trial". Lancet. 1 (8426): 415–419. ISSN 0140-6736. PMID 2857803. Unknown parameter
|coauthors=
ignored (help) - ↑ Norcott, H. C. (1982-12-27). "Platelet inhibitory drugs: an in vivo method of evaluation in patients". Thrombosis and Haemostasis. 48 (3): 307–310. ISSN 0340-6245. PMID 6761890. Unknown parameter
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ignored (help) - ↑ "DIPYRIDAMOLE tablet, film coated".
- ↑ "http://www.ismp.org". External link in
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