Dipyridamole
Mechanism :
Dipyridamole is a platelet adhesion inhibitor, although the mechanism of action is not fully understood. The mechanism may relate to inhibition of red blood cell uptake of adenosine, itself an inhibitor of platelet reactivity, phosphodiesterase inhibition leading to increased cyclic-3,5-adenosine monophosphate within platelets, and inhibition of thromboxane A2 formation which is a potent stimulator of platelet activation.
Indication :
Contraindications :
Hypersensitivity to dipyridamole and any of the other components.
Dosing :
3-6 mg/kg/day in 3-4 divided doses, orally.
Adverse Effect :
Nausea, diarrhea, throbbing headache, hot flushes, hypotension, dizziness, myalgia, chest pain, abnormal ECG, dizziness.
Interaction :
Adenosine: Dipyridamole has been reported to increase the plasma levels and cardiovascular effects of adenosine.
Cholinesterase Inhibitors: Dipyridamole may counteract the anticholinesterase effect of cholinesterase inhibitors, thereby potentially aggravating myasthenia gravis.
Anticoagulants: Mild bleeding can sometimes occur if anticoagulants and dipyridamole are used concurrently, without altering prothrombin time.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Not dialysed. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
Dipyridamole is primarily eliminated via hepatic metabolism.
Mild to moderate hepatic impairment: No dose adjustment required.
Severe hepatic impairment: Dosing has not been studied. Use with caution.