Home Drug Guide Dipyridamole

Drug Guide

Generic Name

Dipyridamole

Brand Names Persantine, IV Persantine

Classification

Therapeutic: Antiplatelet agent, Vasodilator

Pharmacological: Phosphodiesterase inhibitor

FDA Approved Indications

Prevention of thromboembolism after heart valve surgery
Adjunct to anticoagulation therapy in certain patients

Mechanism of Action

Inhibits platelet aggregation by increasing intracellular levels of cyclic AMP through inhibition of phosphodiesterase; also causes vasodilation by increasing nitric oxide release.

Dosage and Administration

Adult: Typically 75-100 mg four times daily for oral therapy; IV dosing varies, usually 0.5-2 mg/min infusion

Pediatric: Not generally used in pediatric population; consult specific guidelines

Geriatric: Adjust dose based on response and tolerability

Renal Impairment: Use with caution; monitor renal function and bleeding risk

Hepatic Impairment: Use caution; dose adjustments may be necessary

Pharmacokinetics

Absorption: Well absorbed orally

Distribution: Widely distributed, crosses the blood-brain barrier

Metabolism: Primarily hepatic, via conjugation

Excretion: Renal excretion of metabolites

Half Life: About 10-12 hours

Contraindications

Hypersensitivity to dipyridamole or components
History of bleeding disorders
Severe hypotension

Precautions

Use with caution in patients with bleeding risk, severe hepatic impairment, or during pregnancy and lactation; monitor for bleeding and hypotension

Adverse Reactions - Common

Headache (Common)
Dizziness (Common)
Gastrointestinal discomfort (Common)

Adverse Reactions - Serious

Bleeding (Serious)
Hypotension (Serious)
Allergic reactions including rash, angioedema (Serious)

Drug-Drug Interactions

Anticoagulants (e.g., warfarin, heparin) — increased bleeding risk
Other vasodilators — additive hypotensive effect

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of bleeding, blood pressure, and neurological status

Diagnoses:

Risk for bleeding
Ineffective tissue perfusion

Implementation: Administer as prescribed, monitor INR if on anticoagulants, observe for adverse effects

Evaluation: Assess efficacy in preventing thromboembolism and monitor for side effects

Patient/Family Teaching

Report unusual bleeding or bruising
Inform about potential headaches and dizziness
Advise to avoid abrupt cessation of medication

Special Considerations

Black Box Warnings: N/A

Genetic Factors: N/A

Lab Test Interference: May affect bleeding-related lab tests, INR, and bleeding time

Overdose Management

Signs/Symptoms: Excessive bleeding, hypotension

Treatment: Supportive care, stopping the drug, blood transfusions if necessary, and monitoring hemostasis

Storage and Handling

Storage: Store at room temperature, 20-25°C, protected from light and moisture

Stability: Stable until the expiration date on the label