Description of the active substance:
This information is a reference and it is not enough that the drug was prescribed by a doctor. .
PHARMACHOLOGIC EFFECT
Antiaggregant, angioprotector, immunomodulator. Has a retarding effect on the aggregation of platelets, improves microcirculation.
Has vasodilator effect, reduces the resistance of resistive coronary vessels (mainly arterioles), increases the volume rate of coronary blood flow. Is able to reduce the perfusion of ischemic zones of the myocardium.
The mechanism of action is not finally clarified. It is believed that dipyridamole increases the adenosine content (disrupting its reuptake), and also promotes an increase in the concentration of cAMP due to inhibition of the enzyme PDE.
As a pyrimidine derivative, dipyridamole is an inducer of interferon and has a modulating effect on the functional activity of the interferon system, increases the decreased production of interferon alfa and interferon gamma by leukocytes in vitro. Increases nonspecific resistance to viral infections.
PHARMACOKINETICS
After oral administration, dipyridamole is completely absorbed from the digestive tract. C max in blood plasma is achieved after 75 min. The binding with plasma proteins is high.
T 1/2 in the terminal phase is 10-12 hours.
Metabolized in the liver and excreted with bile mainly in the form of glucuronides. Excretion can be slowed down by enterohepatic recirculation. In a small amount is excreted in the urine.
INDICATIONS
Treatment and prevention of cerebral circulation disorders by ischemic type; encephalopathy; prevention of arterial and venous thrombosis and their complications;prevention of thromboembolism after surgery for prosthetic heart valves; prevention of placental insufficiency in a complicated pregnancy; disorders of microcirculation of any type (as part of complex therapy); prevention and treatment of influenza, ARVI (as an inducer of interferon and immunomodulator).
DOSING MODE
When administered orally, the dose is 50-600 mg / day, the frequency of reception depends on the indications.
SIDE EFFECT
From the digestive system: nausea, vomiting, diarrhea.
From the side of the cardiovascular system: when used in high doses - arterial hypotension, hot flashes, tachycardia (especially with simultaneous reception of vasodilators).
From the side of the central nervous system: dizziness, headache.
Allergic reactions: skin rash, hives.
Other: myalgia; in some cases - increased bleeding during or after surgery.
CONTRAINDICATIONS
Acute myocardial infarction, widespread stenosing coronary artery atherosclerosis, unstable angina, subaortic stenosis of the aorta, decompensated heart failure, severe arterial hypotension, severe cardiac arrhythmias, a tendency to bleeding, severe renal failure, hypersensitivity to dipyridamole.
PREGNANCY AND LACTATION
Application in pregnancy, especially in the II and III trimesters, is possible in cases of extreme necessity.
APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in severe renal failure.
SPECIAL INSTRUCTIONS
Use with caution in patients with arterial hypotension, recent myocardial infarction, heart failure.
There is evidence that with IV injection of dipyridamole, there may be an uneven redistribution of blood flow in the coronary vessels and the development of the steal syndrome, accompanied by aggravation of the symptoms of angina (including depression of the ST segment on the ECG). In this regard, is not recommended iv introduction of dipyridamole.
DRUG INTERACTION
With the simultaneous use of drugs that reduce the acidity of the contents of the stomach (antacids, blockers of histamine H 2 receptors (including cimetidine), inhibitors of the proton pump (including omeprazole), the bioavailability of dipyridamole may decrease.
When used simultaneously with anticoagulants, acetylsalicylic acid, the antiplatelet effect of dipyridamole is enhanced.
With simultaneous use with anticholinergic drugs, memory and attention disorders may occur in elderly patients.
With simultaneous use with beta-blockers, cases of bradycardia and asystole are described with dipyridamole in patients receiving beta-blockers.
With simultaneous use with adenosine, the effect of adenosine is enhanced.
When used simultaneously with dobutamine, there is a risk of developing severe arterial hypotension.
When used simultaneously with caffeine, other xanthine derivatives, the effectiveness of dipyridamole decreases.
