Dipiridamol

When ATH:
B01AC07

Characteristic.

Crystalline yellow powder, with a bitter taste, without smell. It is soluble in dilute acids, methanol and chloroform and practically insoluble in water.

Pharmacological action.
Antiagregatine, antiadgezivnoe, vasodilator, arteriodilatirtee.

Application.

Prevention of thromboembolic syndrome after operation prosthetic heart valves, prevention of stent occlusion of coronary artery bypass grafts (in combination with acetylsalicylic acid), peripheral vascular lesions (incl. chronic obliterating vascular diseases of the lower extremities, especially in the presence of risk factors (arterial hypertension, smoking), prevention of placental insufficiency at the complicated pregnancy, treatment and prophylaxis of disseminated intravascular coagulation in children with infectious toxicosis and septicemia, three-component treatment of glomerulonephritis (Combination Therapy), the suppression of platelet syndrome in children, holding dipyridamole thallium-201-perfusion scintigraphy with physical activity, dipyridamole stress echocardiography.

Contraindications.

Hypersensitivity, acute myocardial infarction, expressed atherosclerotic lesions of the coronary vessels with a developed system of collaterals, predisposition to hypotension, severe liver, hemorrhagic diathesis, obstructive pulmonary disease, expressed disturbances of intraventricular conduction, severe hypertension, II and III trimesters of pregnancy, childhood and adolescence (to 12 years).

Side effects.

Nausea, discomfort in the abdomen, headache, dizziness, redness of the face, coronary steal syndrome (aggravation of coronary artery disease), thrombocytopenia, changes in the functional properties of platelets, bleeding, hypotension, tachycardia, bradycardia, weakness, rash.

Cooperation.

Antacids decrease the maximum concentration due to lower absorption. Aspirin and enhance the effects of indirect anticoagulants, xanthine derivatives weaken (especially koronarorasshiryayuschee), heparin increases the risk of bleeding complications.

Overdose.

Symptoms: transient hypotension.

Treatment: introduction of vasopressor agents.

Dosing and Administration.

Inside, for 1 hour before meals. As means antiagregatsionnogo 75-100 mg 3-4 times / day. For the prevention of thromboembolic syndrome, stent thrombosis coronary artery bypass grafts - the first day of 50 mg 4 times / day with acetylsalicylic acid, then - on 100 mg 4 times / day (overturned by 7 day after surgery subject to continued aspirin receiving a dose 325 mg / day). Another possible scheme: 100 mg 4 twice a day for 2 the day before the operation and 100 mg after 1 hours after surgery (optionally in combination with warfarin). For the treatment of chronic obliterating diseases of lower limb arteries - 75 mg 3 once a day; treatment 2-3 months (it is advisable to combine with low-dose acetylsalicylic acid). For diagnostic purposes - 300-400 mg immediately during stress echocardiography or 45 min prior to injection of the radiopharmaceutical.

Precautions.

If you have coronary steal syndrome to improve intracardiac blood flow shows the assignment of aminophylline. Violation of the liver and biliary tract obstruction necessitate dose reduction.

Cooperation