Dipyridamole tablets p / o 25mg, No. 120 Vertex

• Treatment and prevention of ischemic cerebral circulation disorders;

• encephalopathy;

• primary and secondary prevention of coronary artery disease, especially with intolerance to acetylsalicylic acid (for a dose of 75 mg);

• prevention of arterial and venous thrombosis and their complications;

• prevention of thromboembolism after heart valve replacement surgery; prevention of placental insufficiency in 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).

The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen.

Inside. The dose, the regimen of use and the duration of the course of treatment are determined individually, depending on the indications. The daily dose is 50-600 mg.

Active substance:

dipyridamole - 25 mg

• Hypersensitivity to dipyridamole;

• acute myocardial infarction;

• unstable angina;

• common stenosing 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 12 years of age (efficacy and safety have not been studied).

With caution: elderly patients (due to the risk of orthostatic hypotension).

Clinical and pharmacological group: Antiplatelet. Immunomodulator.

Pharmaco-therapeutic group: Vasodilating agent

pharmachologic effect

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

Has a vasodilating effect, lowers the resistance of resistive coronary vessels (mainly arterioles), increases the volumetric velocity of coronary blood flow. Able to reduce the perfusion of ischemic zones of the myocardium.

The mechanism of action is not fully understood. It is believed that dipyridamole increases the content of adenosine (disrupting its reuptake), and also contributes to an increase in 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, reduces the incidence of deep vein thrombosis in the postoperative period. Improves microcirculation in the retina and renal glomeruli.

In neurological practice, such pharmacodynamic effects of dipyridamole are used as a decrease in the tone of cerebral vessels and an improvement in cerebral circulation. According to angiographic studies, the use of dipyridamole in combination with acetylsalicylic acid can slow the progression of atherosclerosis.

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

It is metabolized in the liver and excreted in the bile mainly in the form of glucuronides. Excretion may be slowed down by enterohepatic recirculation. A small amount is excreted in the urine.

Indications

• Treatment and prevention of ischemic cerebral circulation disorders;

• encephalopathy;

• primary and secondary prevention of coronary artery disease, especially with intolerance to acetylsalicylic acid (for a dose of 75 mg);

• prevention of arterial and venous thrombosis and their complications;

• prevention of thromboembolism after heart valve replacement surgery;

• prevention of placental insufficiency in 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).

Dosage regimen

The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen.

Inside. The dose, the regimen of use and the duration of the course of treatment are determined individually, depending on the indications. The daily dose is 50-600 mg.

Side effect

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

From the side of the cardiovascular system: infrequently - arterial hypotension, hot flashes, tachycardia (especially while taking vasodilators); coronary steal syndrome (when used in 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 : infrequently - nausea, vomiting, diarrhea, epigastric pain.

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

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

Allergic reactions: skin rash, urticaria.

Others: the frequency is unknown - weakness, flushing of the skin of the face, arthritis, myalgia, rhinitis.

Contraindications for use

• Hypersensitivity to dipyridamole; acute myocardial infarction;

• unstable angina;

• common stenosing 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 12 years of age (efficacy and safety have not been studied).

With caution: elderly patients (due to the risk of orthostatic hypotension).

Application during pregnancy and lactation

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

Application for violations of liver function

Use in liver failure is contraindicated.

Application for impaired renal function

Use is contraindicated in severe renal failure.

Application in children

Use in children under 12 years of age is contraindicated (efficacy and safety have not been studied).

Use in elderly patients

It is prescribed with caution in elderly patients because of the risk of developing orthostatic hypotension.

special instructions

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

There is evidence that with intravenous administration of dipyridamole, an uneven redistribution of blood flow in the coronary vessels and the development of steal syndrome, accompanied by an aggravation of the symptoms of angina pectoris (including depression of the ST segment on the ECG), is possible. In this regard, patients who are constantly taking oral dipyridamole cannot be additionally prescribed intravenously.

Drug interactions

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

With simultaneous use with anticoagulants, acetylsalicylic acid, the antiplatelet effect of dipyridamole is enhanced.

With simultaneous use with anticholinergics, memory and attention impairment in elderly patients is possible.

With simultaneous use 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.

With simultaneous use with dobutamine, there is a risk of severe arterial hypotension.

Xanthine derivatives (coffee, tea, theophylline derivatives) can weaken the vasodilating effect of dipyridamole.

Dipyridamole enhances the effect of antihypertensive drugs.

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

Cephalosporins enhance the antithrombotic effect of dipyridamole.

Storage conditions:

In a dark place at a temperature not exceeding 25 ? C.

Keep out of the reach of children.

Shelf life:

3 years.

Do not use after the expiration date.

Vacation conditions

On prescription