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dipyridamole (Persantine)
Tradename: Persantine.
Indications:
1) adjunct to coumadin in prevention of thromboembolic complications of cardiac valve replacement
2) used for platelet aggregation inhibition in other disorders
- transient ischemic attack
3) used as diagnostic agent in myocardial perfusion scintigraphy (Persantine stress test) to evaluate coronary artery disease in patients unable to exercise
4) adjunct to aspirin (Aggrenox) for secondary prevention in patients with cardiovascular disease
5) inferior to warfarin for treatment of hypercoagulability
Contraindications:
1) bronchospasm, severe asthma
2) hypotension
3) sick sinus syndrome
4) AV block (high degree)
Dosage:
1) 75-100 mg PO TID-QID
2) ECG stress testing: 0.57 mg/kg over 4 minutes
Tabs: 25, 50, 75 mg. [1]
Injection: 5 mg/mL (2 mL)
Antidote: aminophylline 100 mg IV.
Pharmacokinetics:
1) incompletely absorbed from the GI tract
2) highly bound to plasma proteins, primarily albumin
3) 1/2life is 10-12 hours
4) metabolized by the liver
5) excreted in the bile
Adverse effects:
1) oral [2]
- dizziness
- headache
- abdominal discomfort - diarrhea (common)
- rash
2) intravenous [2]
- ventricular fibrillation
- actue myocardial infarction
- transient cerebral ischemia
- chest pain
- flushing
- leg cramps
- dyspepsia
- tachycardia
- anxiety
- neutropenia
- headache
- bronchospasm
3) uncommon (< 1%) [3]
- syncope
- vasodilation
- hypertonia
- rhinitis
- edema
- allergic reaction
Drug interactions:
1) may increase risk of bleeding when administered with heparin
2) theophylline & aminophylline antagonize effects of dipyridamole
Mechanism of action:
1) dipyridamole dilates normal coronary arteries, but has little effect on stenotic vessels
2) inhibition of platelet aggregation
3) inhibition of erythrocyte uptake & metabolism of adenosine by inhibiting adenosine deaminase
4) inhibition of platelet phosphodiesterase leading to an increased in platelet cAMP
5) may stimulate release of prostacyclin or PG2
Interactions
drug interactions
drug adverse effects (more general classes)
Related
myocardial perfusion & viability scintigraphy
General
antiplatelet agent
vasodilator agent
Properties
MISC-INFO: elimination route LIVER
1/2life 8-10 HOURS
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM cid=3108
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- UpToDate 13.3
http://www.utdol.com
- Deprecated Reference
Component-of
aspirin/dipyridamole (Aggrenox)