Dipyridamole

Dipyridamole [one tablet 19 cents] ADMINISTRATION ROUTES:

PO, NG

ALTERNATIVE NAMES: Persantin, Pytazen

ICU INDICATIONS: 1. adjunct to oral anticoagulants in circumstances where there is high risk of

thrombosis.

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)

DOSAGE:

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:

PO

1-2mg/kg 6-8 hourly oral See PRECAUTIONS Paediatric Use

CLINICAL PHARMACOLOGY: Platelet aggregation inhibitor

CONTRAINDICATIONS 1. Hypersensitivitytodipyridamole

WARNINGS See PRECAUTIONS

PRECAUTIONS

General:

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:

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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.

Laboratory Tests:

No tests in addition to standard ICU tests are required

Drug/Laboratory Test Interactions:

None known

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.

ADVERSE REACTIONS

Body as a Whole:

Fatigue, malaise, myalgia

Neurological System:

Headache

Cardiovascular System:

Hypotension, palpitations, and tachycardia

Respiratory System:

severe bronchospasm, larynx oedema, angioedema

Gastrointestinal System:

Cholelithiasis, nausea, diarrhea, vomiting, hepatitis.

Dermatological System:

Rash, urticaria

Haematological System:

thrombocytopenia