Dipyridamole

From Wikipedia, the free encyclopedia - View original article

Dipyridamole
Systematic (IUPAC) name
2,2',2'',2'''-(4,8-di(piperidin-1-yl)pyrimido[5,4-d]pyrimidine-2,6-diyl)bis(azanetriyl)tetraethanol
Clinical data
Trade namesPersantine
AHFS/Drugs.commonograph
MedlinePlusa682830
Pregnancy cat.B
Legal statusPOM (UK) -only (US)
Routesoral, IV
Pharmacokinetic data
Protein binding99%
MetabolismHepatic
Half-lifeAlpha (40 mins), Beta (10 Hours)
Identifiers
CAS number58-32-2 YesY
ATC codeB01AC07
PubChemCID 3108
DrugBankDB00975
ChemSpider2997 YesY
UNII64ALC7F90C YesY
KEGGD00302 YesY
ChEBICHEBI:4653 YesY
ChEMBLCHEMBL932 YesY
Chemical data
FormulaC24H40N8O4 
Mol. mass504.626 g/mol
 YesY (what is this?)  (verify)
 
  (Redirected from Aggrenox)
Jump to: navigation, search
Dipyridamole
Systematic (IUPAC) name
2,2',2'',2'''-(4,8-di(piperidin-1-yl)pyrimido[5,4-d]pyrimidine-2,6-diyl)bis(azanetriyl)tetraethanol
Clinical data
Trade namesPersantine
AHFS/Drugs.commonograph
MedlinePlusa682830
Pregnancy cat.B
Legal statusPOM (UK) -only (US)
Routesoral, IV
Pharmacokinetic data
Protein binding99%
MetabolismHepatic
Half-lifeAlpha (40 mins), Beta (10 Hours)
Identifiers
CAS number58-32-2 YesY
ATC codeB01AC07
PubChemCID 3108
DrugBankDB00975
ChemSpider2997 YesY
UNII64ALC7F90C YesY
KEGGD00302 YesY
ChEBICHEBI:4653 YesY
ChEMBLCHEMBL932 YesY
Chemical data
FormulaC24H40N8O4 
Mol. mass504.626 g/mol
 YesY (what is this?)  (verify)

Dipyridamole (trademarked as Persantine) is a medicine that inhibits thrombus formation[1] when given chronically and causes vasodilation when given at high doses over a short time.

Mechanism and effects[edit]

Medical uses[edit]

Use in individuals with a history of stroke[edit]

Modified release dipyridamole is used in conjunction with aspirin (under the trade names Aggrenox in the USA or Asasantin Retard in the UK) in the secondary prevention of stroke and transient ischaemic attack. This practice has been confirmed by the ESPRIT trial.[3] Dipyridamole absorption is pH-dependent and concomitant treatment with gastric acid suppressors (such as a proton pump inhibitor) will inhibit the absorption of liquid & plain tablets.[4][5] Modified release preparations are buffered and absorption is not affected.[6][7]

It is not, however, licensed as monotherapy for stroke prophylaxis, although a Cochrane Review has suggested that dipyridamole may reduce the risk of further vascular events in patients presenting after cerebral ischaemia.[8]

A triple therapy of aspirin, clopidogrel, and dipyridamole has been investigated, but this combination led to an increase in adverse bleeding events.[9]

Other uses[edit]

Dipyridamole also has non-medicinal uses in a laboratory context, such as the inhibition of cardiovirus growth in cell culture.

Overdose[edit]

Dipyridamole
Classification and external resources
ICD-10T46.3
ICD-9972.4
DiseasesDB3840

Dipyridamole overdose can be treated with aminophylline[10] which reverses its hemodynamic effects (vasodilation). Symptomatic treatment is recommended, possibly including a vasopressor drug. Gastric lavage should be considered. Administration of xanthine derivatives (e.g., aminophylline) may reverse the hemodynamic effects of dipyridamole overdose. Since dipyridamole is highly protein bound, dialysis is not likely to be of benefit.

See also[edit]

References[edit]

  1. ^ "Dipyridamole" at Dorland's Medical Dictionary
  2. ^ Dipyridamole in the laboratory: Fata-Hartley, Cori L.; Ann C. Palmenberg. "Dipyridamole reversibly inhibits mengovirus RNA replication". doi:10.1128/JVI.79.17.11062-11070.2005. Retrieved 2007-02-13. 
  3. ^ Halkes PH, van Gijn J, Kappelle LJ, Koudstaal PJ, Algra A (May 2006). "Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial". Lancet 367 (9523): 1665–73. doi:10.1016/S0140-6736(06)68734-5. PMID 16714187. 
  4. ^ Russell TL, Berardi RR, Barnett JL, O’Sullivan TL, Wagner JG, Dressman JB. pH-related changes in the absorption of "dipyridamole" in the elderly. Pharm Res (1994) 11 136–43.
  5. ^ Derendorf H, VanderMaelen CP, Brickl R-S, MacGregor TR, Eisert W. "Dipyridamole" bioavailability in subjects with reduced gastric acidity. J Clin Pharmacol (2005) 45, 845–50.
  6. ^ http://emc.medicines.org.uk/medicine/304/SPC/Persantin+Retard+200mg/#EXCIPIENTS
  7. ^ Stockley, Ivan (2009). Stockley’s Drug Interactions. The Pharmaceutical Press. ISBN 0-85369-424-9. 
  8. ^ De Schryver ELLM, Algra A, van Gijn J. (2007). "Dipyridamole for preventing stroke and other vascular events in patients with vascular disease.". In Algra, Ale. Cochrane Database of Systematic Reviews (2): CD001820. doi:10.1002/14651858.CD001820.pub3. PMID 17636684. 
  9. ^ Sprigg N, Gray LJ, England T, et al. (2008). "A randomised controlled trial of triple antiplatelet therapy (aspirin, clopidogrel and dipyridamole) in the secondary prevention of stroke: safety, tolerability and feasibility". In Berger, Jeffrey S. PLoS ONE 3 (8): e2852. doi:10.1371/journal.pone.0002852. PMC 2481397. PMID 18682741. 
  10. ^ Aggrenox. RxList.com. URL: http://www.rxlist.com/cgi/generic/aggrenox_od.htm. Accessed on: May 1, 2007.