Universal reference book for medicines
Product name: SANOMYL-SANOVEL (SANOMYL-SANOVEL)

Active substance: dipyridamole

Type: Antiaggregant.
Myotropic vasodilator
Manufacturer: SANOVEL PHARMACEUTICAL PRODUCTS Ind.
(Turkey)
Composition, form of production and packaging
The tablets covered with a cover of
yellow color, round, planocylindrical.

1 tab.

dipyridamole 75 mg

[PRING] lactose monohydrate, corn starch, gelatin, sodium carboxymethyl starch (type A), silicon dioxide colloid, magnesium stearate, hypromellose, talc, titanium dioxide (E171), macrogol 6000, quinoline yellow (E104), simethicone emulsion.

10 pieces.
- blisters (5) - packs of cardboard.
20 pcs.
- blisters (2) - packs of cardboard.
20 pcs.
- blisters (3) - packs of cardboard.
20 pcs.
- blisters (5) - packs of cardboard.
INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2011.

PHARMACHOLOGIC EFFECT

Dipiridamole dilates the coronary vessels (mostly arterioles) and causes a significant increase in the volumetric flow velocity.
Increases the oxygen content in the venous blood of the coronary sinus and its absorption by the myocardium. Promotes the development of collateral coronary circulation, reduces the overall peripheral resistance of blood vessels, improves microcirculation, has an angioprotective effect. These effects are due to the increased activity of endogenous adenosine due to a decrease in its capture by tissues and destruction (adenosine affects the smooth muscle of blood vessels and prevents the release of norepinephrine).
It is an antagonist of the endogenous adenosine diphosphate (ADP) aggregate, inhibits phosphodiesterase, while the release of platelet aggregation activators - thromboxane, ADP, serotonin and others - decreases, increases the synthesis of prostagicycin Pgh by endothelium of the vascular tissue, which inhibits platelet aggregation.
Reduces adhezivnost platelets, prevents the formation of clots in the blood vessels and reduce blood flow in the source of ischemia. Antiaggregant effect occurs when the concentration in the plasma is 0.1 μg / ml. Dose-dependent extends the abnormally shortened lifetime of thrombocytes. Expands coronary arteries, especially unchanged, causes the phenomenon of stealing. It is an interferon inducer, has a modulating effect on the functional activity of the interferon system, increases the decreased production of interferon alpha and gamma-leukocytes in vitro. Increases nonspecific antiviral resistance to viral infections.
Normalizes venous outflow, reduces the incidence of deep vein thrombosis in the postoperative period.
Improves microcirculation in the retina of the eye, renal glomeruli. Reduces the tone of the cerebral vessels, it is effective for dynamic disorders of cerebral circulation.
PHARMACOKINETICS

When ingested quickly absorbed in the stomach (most) and the small intestine.
Bioavailability is 37-66%. After ingestion C max of dipyridamole in plasma is achieved within 40-60 minutes. It binds to plasma proteins by 80-95%. Quickly penetrates into the tissue. It accumulates in large quantities in the heart and red blood cells. T 1/2 - 20-30 minutes in the first phase, in the second phase - about 10 hours. It is metabolized in the liver with the formation of monoglyucuronide, which is excreted in the bile (20% of the drug is included in enterohepatic circulation). Possible cumulation (mainly in patients with impaired liver function).
INDICATIONS

- thrombosis and thromboembolism (prophylaxis of arterial and venous thrombi, including after the operation of prosthetic valve of the heart);

- Prevention of occlusion of stents and coronary artery bypass grafts (in combination with acetylsalicylic acid);

- Treatment and prevention of cerebral circulation disorders according to the ischemic type;

- encephalopathy;

- disorders of microcirculation of any genesis (as part of complex therapy).

DOSING MODE

Inside, on an empty stomach or 1 hour before a meal, squeezed a small amount of water or milk.

For the prevention and treatment of thromboembolic complications as monotherapy - 75 mg 3-6 times / day;
a daily dose of 300-450 mg, if necessary - 600 mg; in combination with oral anticoagulants or with acetylsalicylic acid - 75 mg 3 times / day.
For prophylaxis of thromboembolic syndrome, stent thrombosis and coronary artery bypass grafts - 50 mg together with acetylsalicylic acid on day 1, then 100 mg each, the frequency of reception is 4 times / day (cancellation 7 days after the operation, if the dose of acetylsalicylic acid is continued in a dose 325 mg / day) or 100 mg 4 times / day for 2 days before the operation and 100 mg 1 h after the operation (if necessary in combination with warfarin).

In case of coronary insufficiency , 25-50 mg 3 times / day;
in severe cases at the beginning of treatment - 75 mg 3 times / day, then reduce the dose; daily dose of 150-200 mg.
SIDE EFFECT

From the cardiovascular system: palpitation, tachycardia, bradycardia, blood flow to the face, coronary steal syndrome (with doses more than 225 mg / day), lowering blood pressure.

From the digestive system: nausea, vomiting, diarrhea, epigastric pain.

On the part of the blood and hemostasis system: thrombocytopenia, changes in the functional properties of platelets, bleeding, increased bleeding.

Other: weakness, dizziness, sensation of stuffiness in the ear, noise in the head, headache, hyperemia of the skin of the face, arthritis, myalgia, rhinitis, allergic reactions.

CONTRAINDICATIONS

acute myocardial infarction;

- widespread sclerosing atherosclerosis of the coronary arteries;

- unstable angina;

- hypertrophic obstructive cardiomyopathy;

Decompensated chronic heart failure;

- arterial hypotension;

- severe arterial hypertension;

- severe disturbances of the heart rhythm;

- hemorrhagic diathesis;

- Stomach ulcer and duodenal ulcer (tendency to bleeding)

- chronic obstructive pulmonary disease;

- kidney failure

- liver failure;

- Children's age (up to 18 years);

- Hypersensitivity to the components of the drug.

PREGNANCY AND LACTATION

Dipyridamole can be used in pregnancy, if only the expected therapeutic effect justifies the potential risk to the fetus, which should especially be taken into account in the first trimester of pregnancy.

Dipiridamole penetrates into the mother's milk, so that dipyridamole can not be used during lactation.

APPLICATION FOR FUNCTIONS OF THE LIVER

Contraindicated in renal failure.

APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS

Contraindicated in liver failure.
Cumulation is possible in patients with impaired liver function.
APPLICATION FOR CHILDREN

Contraindicated in children under 18 years.

SPECIAL INSTRUCTIONS

To reduce the dyspeptic phenomena are taken with milk.

In the treatment should be avoided the use of coffee and tea, weakening the effect of dipyridamole.

In the syndrome of coronary stealing to improve intracardiac blood flow, the appointment of aminophylline is indicated.

OVERDOSE

In case of an overdose, headache, gastrointestinal disorders, and a decrease in blood pressure are observed.
With a decrease in blood pressure, if necessary, short-term intake of vasopressor drugs is recommended. In patients with coronary heart disease, coronary vasodilation can lead to chest pain. The chest pains and bronchospasm are eliminated by immediate intravenous injection of aminophylline and nitroglycerin.
In case of an overdose, general symptomatic treatment is performed.

DRUG INTERACTION

The antiplatelet effect is increased with the use of indirect anticoagulants, acetylsalicylic acid, penicillin series antibiotics, cephalosporins, tetracyclines, chloramphenicol, nicotinic acid.

The xanthine derivatives containing caffeine weaken the antithrombotic effect.
Weaken the effect of cholinesterase inhibitors.
Antacids reduce the maximum concentration due to reduced absorption.

Heparin, indirect anticoagulants, thrombolytics increase the risk of hemorrhagic complications.

TERMS OF RELEASE FROM PHARMACY

The drug is released by prescription.

TERMS AND CONDITIONS OF STORAGE

List B.

Store the drug in a dry place at a temperature of no higher than 25 ° C.
Keep out of the reach of children.
Shelf life 3 years.
Do not use after the expiration date printed on the package.
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