Medication Description: Dipyridamole (Dipyridamolum)
DIPYRIDAMOL (Dipyridamolum). 2, 6-Bis- [bis- (b -oxyethyl) amino] -4, 8-di-N-piperidino-pyrimido (5, 4-d) pyrimidine.
Synonyms: Curantil, Persanthin, Anginal, Antistenocardin, Apricor, Cardioflux, Corinon, Corosan, Coroxin, Curantyl, Dilcor, Dipiridamole, Dirinol, Novodil, Padicor, Peridamol, Persantin, Stenocardil, Trancocard, Iris, Padicor, Peridamol, Persantin, Stenocardil, Trancocard, Iris, Padicor, Peridamol, Persantin, Stenocardil, Trancocard, I, Padicor, Peridamol, Persantin, Stenocardil
Yellow crystalline powder. It is difficult to dissolve in water.
Dipyridamole was originally proposed as a coronary expanding (antianginal) agent.
According to experimental data, the drug expands coronary vessels, increases the volumetric rate of coronary blood flow, improves the supply of oxygen to the myocardium. Increases myocardial tolerance to hypoxia. In case of circulatory disorders in the main coronary vessels, the drug improves blood circulation in the collateral vascular network. Under its influence, general peripheral resistance also decreases, systemic blood pressure decreases somewhat, and cerebral circulation improves.
In the mechanism of the vasodilating action of dipyridamole, an increase in the formation of adenosine, one of the participants in the autoregulation of coronary blood flow, plays a significant role. 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 the vessels. Apparently, the drug stimulates the biosynthesis of prostacyclin and inhibits the synthesis of thromboxanes (see Prostaglandins).
As a coronary diluent, dipyridamole is currently of limited use. Used occasionally for chronic ischemic heart disease.
It is taken orally (on an empty stomach 1 hour before meals) at 0.025-0.05 g (1-2 pills of 0.025 g) 3 times a day. In more severe cases, 0.225 g (225 mg - 3 pills of 0.075 g) per day in 3 divided doses. The course of treatment lasts from several weeks to several months.
Dipyridamole administered intravenously (as previously suggested in cases of acute strokes) is not recommended. There is evidence that in this case there may be an uneven redistribution of blood flow in the coronary vessels (the stealing phenomenon), accompanied by an increase in the effects of angina pectoris with depression on the ECG of the ST segment.
Mainly used as an antiplatelet agent for the prevention of postoperative thrombosis, with myocardial infarction, disorders of cerebral circulation.
There is evidence of improvement in dipyridamole rheological parameters and renal function in patients with chronic glomerulonephritis.
Dipyridamole affects arachidonic acid metabolism and contributes to an increase in prostacyclin production in the walls of blood vessels.
By antiaggregation activity dipyridamole is inferior to ticlopidine, close to acetylsalicylic acid. However, it is better tolerated than acetylsalicylic acid, does not have an ulcerogenic effect.
Is taken orally as an antithrombotic agent for 0.025 g (25 mg) 3 times a day.