Dipiridamolum

Dipiridamolum – vazodilatiruyushchy drug.

Form of release and structure

Dosage forms:

• Tablets, coated (on 10 pieces in a blister strip packaging, in a cardboard pack: on 25 and 50 mg – 5 or 10 packagings, on 75 mg – 4 or 10 packagings);
• Suspension for intake: bright yellow liquid with a characteristic smell of almonds (on 150 ml in bottles from orange glass (type III), in a cardboard pack 1 bottle).

Active agent – Dipiridamolum:

• 1 tablet – 25, 50 or 75 mg;
• 5 ml of suspension – 50 mg.

Suspension excipients: ammonium glycyrrhizinate, magnesium aluminum silicate, propylene glycol (E1520), polysorbate 80, мальтитол liquid (E965), sodium hydroortho-phosphate anhydrous (E339), citric acid of monohydrate solution of 5%, an emulsion of a simetikon of 30% (Q7-2587), left menthol, methylparahydroxybenzoate (E218), sodium of hydroortho-phosphate anhydrous solution of 5%, пропилпарагидроксибензоат (E216), gum xanthane (E415), fragrance Almonds (F31209) (propylene glycol and ethanol are a part), citric acid monohydrate (E330), the water purified.

Indications to use

• Prevention and treatment of disturbances of cerebral circulation on ischemic type;
• Distsirkulyatorny encephalopathy;
• Prevention of venous and arterial thromboses and their complications;
• Prevention of a thromboembolism after surgical intervention on prosthetics of valves of heart;
• As a part of complex treatment of all types of disturbance of microcirculation;
• Prevention and treatment of the acute respiratory viral infections (ARVI), flu, as an immunomodulator and the inductor of interferon (only tablets).

Besides, tablets of Dipiridamolum apply at the complicated pregnancy to prevention of placental insufficiency.

Contraindications

• The acute myocardial infarction, unstable stenocardia widespread the stenosing atherosclerosis of coronary vessels;
• Dekompensirovanny heart failure;
• Subaortal stenosis;
• The expressed arterial hypotension;
• Heavy disturbances of a cordial rhythm;
• The expressed renal failure;
• Tendency to bleedings;
• Hypersensitivity to Dipiridamolum and auxiliary components of drug.

Contraindications to suspension use also are:

• Liver failure;
• Heavy arterial hypertension;
• Hypertrophic subaortic stenosis;
• Hemorrhagic diathesis;
• Chronic obstructive pulmonary disease;
• Diseases with tendency to bleedings, including stomach ulcer and a duodenum;
• Age up to 18 years.

Dipiridamolum should be taken with caution:

• Tablets: the patient with recently postponed myocardial infarction; arterial hypotension; heart failure; at pregnancy, in urgent cases, especially in the II-III trimesters;
• Suspension: diseases of coronary arteries, including a state after a myocardial infarction and/or unstable stenocardia; disturbances of coagulability of blood; during pregnancy and breastfeeding, only in cases when by definition of the doctor the expected effect for mother exceeds potential risk for a fruit and the child (drug cosecretes in breast milk).

Route of administration and dosage

• Tablets: accept inside. The daily dose can fluctuate from 50 to 600 mg, frequency rate of reception and the period of treatment are appointed by the doctor on the basis of clinical indications;
• Suspension: accept inside in 1 hour prior to food. Before each reception it is recommended to shake up bottle contents. Dosing is appointed by the attending physician individually depending on clinical indications, severity of a condition of the patient and his reaction to treatment. The recommended daily dosing: for reduction of aggregation of thrombocytes – 300 mg: on 100 mg (2 teaspoons) 3 times, for hard cases are allowed increase in a daily dose up to 600 mg; prevention of flu and other SARS (it is most urgent during the epidemiological period) – 50 mg (1 teaspoon) once a week, course duration – 4-5 weeks; prevention of a recurrence at the patients who often have viral respiratory infections – 100 mg (2 teaspoons) 2 times a day once a week, duration – 8-10 weeks.

Side effects

Undesirable effects of reception of tablets can become:

• Cardiovascular system: at reception of high doses – inflows, arterial hypotension, tachycardia, are more often at a combination to vazodilatator;
• Alimentary system: nausea, vomiting, diarrhea;
• Nervous system: headache, dizziness;
• Allergic reactions: urticaria, skin rash.

Reception of suspension of Dipiridamolum can cause side effects:

• From blood and system of a homeostasis: infrequently – thrombocytopenia, disturbance of functional properties of thrombocytes; seldom – bleedings; very seldom – the raised bleeding;
• From the alimentary system: infrequently – pain in epigastric area, diarrhea, nausea, vomiting;
• From cardiovascular system: infrequently – rushes of blood to the person, a heart consciousness, bradycardia, tachycardia, a lowering of arterial pressure, a syndrome of coronary burglarizing (at a dose more than 225 mg a day);
• Others: sonitus, weakness, dermahemia of the person, dizziness, headache, feeling of a congestion of an ear, rhinitis, arthritis, allergic reactions (urticaria, rash, Quincke's disease, strong bronchospasm).

Usually, use of suspension in therapeutic doses does not cause the expressed side effects, as a rule, they are temporary.

In rare instances reception of tablets and suspension can cause plentiful bleeding in time or after carrying out surgical intervention and a mialgiya.

At emergence of these or other side effects at use of Dipiridamolum it is necessary to consult with the doctor.

Special instructions

Intravenous administration of Dipiridamolum as there is a risk of development of a syndrome of burglarizing with aggravation of symptoms of stenocardia is not recommended.

At complex therapy of patients with a severe form of a myasthenia, carrying out correction of doses of drugs against the background of reception of Dipiridamolum is necessary.

At constant administration of drug inside, it is not necessary to appoint additional intravenous administration of Dipiridamolum.

In case of need test of loading for diagnosis of diseases of coronary arteries, administration of drug inside should be cancelled in 24 hours prior to its intravenous administration.

Drug can cause side effects in the form of weakness, dizziness and a lowering of arterial pressure therefore during treatment patients need to be careful at all types of activity demanding the high speed of psychomotor reactions, concentration of attention including at control of vehicles.

Medicinal interaction

At simultaneous use of each of dosage forms of Dipiridamolum:

• Anticoagulants (heparin, trombolitik), acetylsalicylic acid – antiagregantny action of tablets and suspension amplifies, the risk of development of hemorrhagic complications increases;
• The drugs reducing arterial pressure – their hypotensive activity increases;
• Antacids, blockers histamine H2 receptors (Cimetidinum), inhibitors of the protonew pump, xanthine derivatives (theophylline, caffeine) – decrease efficiency of Dipiridamolum.

At a concomitant use of Dipiridamolum in the form of tablets:

• Anticholinergics – can cause disturbances of attention and memory in elderly patients;
• Beta adrenoblockers – can cause bradycardia and an asystolia;
• Adenosine – action of adenosine amplifies;
• Dobutaminum – raises risk of heavy arterial hypotension.

At Dipiridamolum suspension combination:

• With cholinesterase inhibitors – decrease in their anticholinergic properties is possible;
• With antibiotics of a tsefalosporinovy row (цефамандол, цефотетан, цефоперазон) – action of Dipiridamolum amplifies.

Terms and storage conditions

To store at a temperature up to 25 °C, tablets – in the dry place. To protect from children.

Period of validity: tablets – 5 years, suspension – 2 years.