Description of the medicine: Dipyridamolum (Dipyridamolum)

DIPIRIDAMOLUM. 2, 6-Bis- [bis ((β-hydroxyethyl) amino] -4,8-di-N-piperidino-pyrimido (5,4-d) pyrimidine.

Synonyms: Curantil, Persantin, Anginal, Antistenocardin, Apricor, Cardioflux, Coribon, Corosan, Coroxin, Curantyl, Dilcor, Dipiridamole, Dirinol, Novodil, Padicor, Peridamol, Persantin, Stenocardil, Trancocard, Vadinar, Viscor and others.

Yellow crystalline powder. Difficultly soluble in water.

Dipyridamole was originally proposed as a coronary-extending (antianginal) agent.

According to experimental data, the drug expands coronary vessels, increases the volume rate of coronary blood flow, improves oxygen supply to the myocardium. Increases myocardial tolerance to hypoxia. When blood circulation is disturbed in the main coronary vessels, the drug promotes improvement of blood circulation in the collateral vascular network. Under its influence, the overall peripheral resistance also decreases, the systemic blood pressure decreases somewhat, the cerebral circulation improves.

In the mechanism of vasodilating action of dipyridamole, an important role is played by the increased formation of adenosine, one of the participants in autoregulation of coronary blood flow. Dipyridamole is a competitive inhibitor of adenosine deaminase, an enzyme that cleaves adenosine.

An important feature of dipyridamole can be called 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 has at present limited use. It is sometimes used for chronic ischemic heart disease.

Is taken orally (on an empty stomach 1 hour before eating) to 0,025-0,05 g (1 - 2 tablets to 0,025 g) 3 times a day. In more severe cases, 0.225 g (225 mg - 3 dragees to 0.075 g) per day in 3 divided doses. The course of treatment lasts from several weeks to several months.

Introduce dipyridamole intravenously (as suggested earlier in cases of acute attacks of angina) is not recommended. There is evidence that there may be an uneven redistribution of blood flow in the coronary vessels (the phenomenon of stealing), accompanied by an increase in the phenomena of angina with depression at the ECG of the ST segment.

Basically, they are used as an antiaggregation agent for preventing postoperative thrombosis, with myocardial infarction, and cerebral circulation disorders.

There are data on the improvement under the influence of dipyridamole rheological indicators and kidney function in patients with chronic glomerulonephritis.

Dipyridamole affects the metabolism of arachidonic acid and promotes an increase in the production of prostacyclin in the walls of the vessels.

According to anti-aggregation activity, dipyridamole is inferior to ticlopidine, close to acetylsalicylic acid. However, it is better tolerated than acetylsalicylic acid, does not have ulcerogenic effects.

Take inside as an antithrombotic agent to 0,025 g (25 mg) 3 times a day.