Description of the medicine: Dipyridamole (Dipyridamolum)
DIPYRIDAMOL (Dipyridamolum). 2, 6-Bis- [bis- (b-hydroxyethyl) amino] -4, 8-di-N-piperidino-pyrimido (5, 4-d) pyrimidine.
Synonyms: Curantyl, Persantine, Anginal, Antistenocardin, Apricor, Cardioflux, Coribon, Corosan, Coroxin, Curantyl, Dilcor, Dipiridamole, Dirinol, Novodil, Padicor, Peridamol, Persantin, Stenocardil, Trancocard, Vadar.
Yellow crystalline powder. It is soluble in water.
Dipyridamole was originally proposed as a coronary-expanding (antianginal) agent.
According to experimental data, the drug dilates the coronary vessels, increases the volumetric rate of coronary blood flow, improves the supply of myocardium with oxygen. Increases myocardial tolerance to hypoxia. In case of circulatory disorders in the main coronary vessels, the drug helps to improve blood circulation in the collateral vasculature. Under its influence, the overall peripheral resistance also decreases, systemic blood pressure decreases slightly, cerebral circulation improves.
In the mechanism of vasodilating action of dipyridamole, an important role is played by an increase in the formation of adenosine, one of the participants in the autoregulation of coronary blood flow. Dipyridamole is a competitive inhibitor of adenosine deaminase, an enzyme that breaks down adenosine.
An important feature of dipyridamole is its ability to inhibit platelet aggregation and prevent the formation of blood clots in blood vessels. Apparently, the drug stimulates prostacyclin biosynthesis and inhibits the synthesis of thromboxanes (see Prostaglandins).
As a coronary-expanding agent, dipyridamole is currently of limited use. It is sometimes used for chronic coronary heart disease.
Take orally (on an empty stomach 1 hour before meals) at 0.025 - 0.05 g (1 - 2 tablets of 0.025 g) 3 times a day. In more severe cases, 0.225 g (225 mg - 3 tablets of 0.075 g) per day in 3 divided doses. The course of treatment lasts from several weeks to several months.
Introducing dipyridamole intravenously (as previously suggested in cases of acute angina attacks) is not recommended. There is evidence that in this case there may be an uneven redistribution of blood flow in the coronary vessels (the robbery phenomenon), accompanied by an increase in angina pectoris with depression on the ST segment ECG.
It is mainly used as an anti-aggregation agent for the prevention of postoperative thrombosis, with myocardial infarction, cerebrovascular accident.
There is evidence of improvement under the influence of dipyridamole rheological parameters and renal function in patients with chronic glomerulonephritis.
Dipyridamole affects the metabolism of arachidonic acid and contributes to an increase in the production of prostacyclin in the walls of blood vessels.
Dipyridamole is inferior to ticlopidine in anti-aggregation activity, and is close to acetylsalicylic acid. However, it is better tolerated than acetylsalicylic acid, does not have an ulcerogenic effect.
It is taken orally as an antithrombotic agent at 0.025 g (25 mg) 3 times a day.