Dipyridamole [one tablet 19 cents] ADMINISTRATION ROUTES:
ALTERNATIVE NAMES: Persantin, Pytazen
ICU INDICATIONS: 1. adjunct to oral anticoagulants in circumstances where there is high risk of
PRESENTATION AND ADMINISTRATION:
PO: Immediate Release Tablets: 25mg tablets (orange) Twice Daily Sustained Release Tablets and Modified Release Capsules: Pytazen SR 150mg tablets (yellow), Persantin Perlongets 150mg Capsules (pink/white)
PO / NG:
Usual dosage 150mg of sustained release twice a day (or equivalent daily dose of immediate release tablets divided and administered 6 to 8 hourly). Use immediate release tablets if administering via NGT
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY: Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
1-2mg/kg 6-8 hourly oral See PRECAUTIONS Paediatric Use
CLINICAL PHARMACOLOGY: Platelet aggregation inhibitor
CONTRAINDICATIONS 1. Hypersensitivitytodipyridamole
WARNINGS See PRECAUTIONS
Coronary Artery Disease: Dipyridamole has a vasodilatory effect and should be used with caution in patients with severe coronary artery disease (e.g., unstable angina or recently sustained myocardial infarction). Chest pain may be aggravated in patients with underlying coronary artery disease who are receiving dipyridamole. Hepatic Insufficiency:
Elevations of hepatic enzymes and hepatic failure have been reported in association with dipyridamole administration.
Hypotension: Dipyridamole should be used with caution in patients with hypotension since it can produce peripheral vasodilation.
No tests in addition to standard ICU tests are required
Drug/Laboratory Test Interactions:
IMPORTANT DRUG INTERACTIONS FOR THE ICU Adenosine: Dipyridamole has been reported to increase the plasma levels and cardiovascular effects of adenosine. Adjustment of adenosine dosage may be necessary. Cholinesterase Inhibitors: Dipyridamole may counteract the anticholinesterase effect of cholinesterase inhibitors, thereby potentially aggravating myasthenia gravis.
Body as a Whole:
Fatigue, malaise, myalgia
Hypotension, palpitations, and tachycardia
severe bronchospasm, larynx oedema, angioedema
Cholelithiasis, nausea, diarrhea, vomiting, hepatitis.