Formulary
Dipyridamole: Indications, Dosing, Side Effects and Interactions
Dipyridamole clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Dipyridamole: Indications, Dosing, Side Effects and Interactions
Dipyridamole clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Secondary prevention of ischaemic stroke (not associated with atrial fibrillation) and transient ischaemic attacks (used alone or with aspirin),Adjunct to oral anticoagulation**
- **Adult** (By Mouth Using Modified-Release Medicines): for prophylaxis of thromboembolism associated with prosthetic heart valves 200 mg twice daily, to be taken preferably with food.
**Adjunct to oral anticoagulation**
- **Adult** (By Mouth Using Immediate-Release Medicines): for prophylaxis of thromboembolism associated with prosthetic heart valves 300-600 mg daily in 3-4 divided doses.
**Kawasaki disease (initiated under specialist supervision) for dipyridamole**
- **Child 1 month-11 years** (By mouth using immediate-release medicines): 1 mg/kg 3 times a day.
**Prevention of thrombus formation after cardiac surgery for dipyridamole**
- **Child 1 month-11 years** (By mouth using immediate-release medicines): 2.5 mg/kg twice daily.
- **Child 12-17 years** (By mouth using immediate-release medicines): 100-200 mg 3 times a day.
Cautions
Coagulation disorders; heart failure; hypotension; left ventricular outflow obstruction; myasthenia gravis (risk of exacerbation); rapidly worsening angina; recent myocardial infarction; severe coronary artery disease Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate with concurrent significant bleeding risk, such as uncontrolled severe hypertension, bleeding diathesis, or recent non-trivial spontaneous bleeding (high risk of bleeding).
Side effects
Common or very common Angina pectoris; diarrhoea; dizziness; headache; myalgia; nausea; skin reactions; vomiting Frequency not known Angioedema; bronchospasm; haemorrhage; hot flush; hypotension; tachycardia; thrombocytopenia
Interactions
**Other interactions (8):**
- Dipyridamole increases the plasma levels and cardiovascular effects of adenosine.
- Adjustment of adenosine dosage should therefore be considered if use with dipyridamole is unavoidable.
- There is evidence that the effects of acetylsalicylic acid and dipyridamole on platelet behaviour are additive.
- When dipyridamole is used in combination with any substance impacting coagulation such as anticoagulants and antiplatelets, the safety profile for these medications must be observed.
- Addition of dipyridamole to acetylsalicylic acid does not increase the incidence of bleeding events.
- When dipyridamole was administered concomitantly with warfarin, bleeding was no greater in frequency or severity than that observed when warfarin was administered alone.
Pregnancy
Not known to be harmful.
Breast feeding
Manufacturers advise use only if essential-small amount present in milk.
Medicinal forms
Solution,Tablet,Capsule,Suspension
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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