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Terms Of Use

DIPYRIDAMOLE (PERSANTIN)

Brand Name(s) : Persantin, Persantin retard
Warnings
Uses
Side Effects
Precautions
Interactions
Overdose

DIPYRIDAMOLE WARNINGS

Dipyridamole should be used with caution in:

  • Pregnancy and breastfeeding
  • People with unstable angina pectoris
  • People with insufficient heart blood flow due to obstruction with certain heart conditions (e.g. aortic stenosis - narrowing of the main artery from the heart)
  • People with severe coronary artery disease
  • People who have recently had a heart attack (myocardial infarction)
  • People with heart failure
  • People with myasthenia gravis (a rare disease with muscle weakness)
  • People with blood clotting (coagulation) disorders
  • People with bleeding problems
  • People taking aspirin (or planning on taking aspirin)
  • People taking medication to lower blood pressure
  • People taking cholinesterase inhibitors (for muscle weakness)
  • People taking adenosine (for heart problems or heart tests)
  • People taking medication to prevent blood clotting, such as warfarin
  • People taking antacids (for indigestion)

It should not be used in:

  • Children
  • People with an allergy to dipyridamole, or any of its ingredients
  • People with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (for 25mg tablet form only, not modified release tablets)

Dipyramidole as an injection should be used in caution with:

  • Young infants
  • People with electrical conduction problems in the heart (first degree heart block)
  • People taking medication to lower blood pressure
  • People taking cholinesterase inhibitors (for muscle weakness)
  • People taking adenosine (for heart problems or heart tests)
  • People taking xanthine derivatives, such as caffeine and theophylline which should be avoided 24 hours before an injection of dipyridamole for myocardial imaging.

Dipyridamole as an injection should not be used:

  • Pregnancy
  • Breastfeeding
  • People already receiving dipyridamole treatment, in the oral form
  • People with an allergy to dipyridamole, or any of its ingredients
  • People with abnormal heart beat (dysrhythmia)
  • People with electrical conduction problems in the heart (a second or third degree atrioventricular block)
  • People with an abnormal heart rhythm condition (sick sinus syndrome)
  • People with unstable angina pectoris, or other heart problems
  • People with severe coronary artery disease
  • People who have recently had a heart attack (myocardial infarction)
  • People who have recently had a stroke
  • People with heart failure
  • People with low blood pressure (hypotension)
  • People with myasthenia gravis (a rare disease with muscle weakness)
  • People with blood clotting (coagulation) disorders
  • People with bronchial asthma, or tendency to bronchospasm
  • People with recent, unexplained fainting

Also see list of precautions and interactions

STORAGE

Asasantin Retard tablets: no special storage conditions are required.

Persantin tablets: store below 30°C.

Oral suspension: store below 25°C. Once the bottle is opened, it can only be used for 1 month

DIPYRIDAMOLE USES

What is it used for?

  • Dipyridamole is used to prevent blood clots.
  • It is an anti-thrombotic agent, sometimes known as a blood thinner.
  • It is used to stop the formation of blood clots by preventing blood cells known as platelets clumping together.
  • In general this drug is used to prevent blood clots in people with replacement heart valves. Dipyridamole prevents platelets sticking to the replacement heart valve and causing a blood clot on the valve. Modified release preparations are used to prevent further strokes or mini-strokes in people who have previously had a stroke or mini-stroke caused by a blood clot in the brain.
  • Benefits of being on this drug can include reducing the risk of a stroke or a mini-stroke (transient ischaemic attack) which can arise if blood clots formed on the valve become detached and travel to the brain.

Listed below are the typical uses of dipyridamole.

  • Preventing blood clots in people with replacement (artificial) heart valves
  • Preventing further strokes or mini-strokes in people who have previously had one due to a blood clot, when given as a modified release preparation
  • Diagnostic tests known as myocardial imaging to see if the heart is working properly, when given by injection

On occasion your doctor may prescribe this medicine to treat a condition not on the above list.

HOW TO USE/TAKE

  • This medication can be taken in tablet, oral suspension or as an injection. This medication is also available as capsules in a modified release form.
  • Tablet and oral suspension form: take this medication orally usually three or four times daily, before food.
  • Modified release capsules: Take this medication orally usually twice daily, preferably with food. It is important that this form of medication is swallowed whole with a glass of water and is not crushed or chewed.
  • Use this medication for duration of the prescription in order to get the most benefit from it.
  • Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
  • It may take some weeks before the full benefit of this drug takes effect.
  • Certain medical conditions may require different dosage instructions as directed by your doctor.
  • Injection: dipyridamole as an injection will be given to you by a doctor or nurse. It is an injection infused over 4 minutes. This medication should then be followed by an injection of thallium-201 for myocardial imaging. People taking regular oral dipyridamole should not also be given the medication as an injection. Patients receiving dipyridamole orally who require diagnostic tests (myocardial imaging) are recommended to discontinue the oral medication for 24 hours beforehand.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • Dipyridamole is not known to affect the ability to drive or operate machinery. Consult your doctor or pharmacist for more details.

When can I stop?

  • It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.

DIPYRIDAMOLE SIDE EFFECTS

  • Headache (normally goes away with long term treatment)
  • Nausea
  • Vomiting
  • Diarrhoea
  • Dizziness
  • Faintness
  • Indigestion
  • Muscle pain
  • Low blood pressure
  • Hot flushes
  • Increased heart rate
  • Worsening chest pain
  • Lowered platelet count leading to:

  • -Bruising more easily
    - Increased bleeding during or after surgery
  • Medication is incorporated into gallstones, in the gall bladder (in people with gallstones)
  • Allergic reactions such as skin rash, hives, swelling and severe breathing difficulties (see below serious allergic reaction)

In addition the following side effects may occur in patients having the injection for diagnostic tests:

  • Death
  • Cardiac arrest
  • Heart attack
  • Heart rhythm changes (on an ECG scan)
  • Temporary loss of consciousness
  • Stroke or mini-stroke
  • Tingling feeling e.g. in toes and hands
  • Bitter taste in mouth
  • Blood pressure changes
  • If any of these persist or you consider them severe then inform doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms: Allergic reaction (see below)

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.

DIPYRIDAMOLE PRECAUTIONS

Before taking dipyridamole, tell your doctor or pharmacist if you are allergic to it; or to other anti-thrombotic agents; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have:

  • An allergy to dipyridamole, or any of its ingredients
  • Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (for 25mg tablet form only, not prolonged release tablets)

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following:

  • Unstable angina pectoris, or other heart problems
  • Severe coronary artery disease
  • Recently had a heart attack (myocardial infarction)
  • Heart failure
  • Myasthenia gravis (a rare disease with muscle weakness)
  • Blood clotting (coagulation) disorders
  • Bleeding problems

Dipyridamole by injection should not be used if you have:

  • An allergy to dipyridamole, or any of its ingredients
  • Certain heart problems including abnormal heart beat, electrical conduction problems (second or third degree atrioventricular block), abnormal heart rhythm (sick sinus syndrome), unstable angina pectoris, severe coronary artery disease, recently had a heart attack (myocardial infarction) or have heart failure
  • Recently had a stroke
  • Low blood pressure (hypotension)
  • Myasthenia gravis (a rare disease with muscle weakness)
  • Blood clotting (coagulation) disorders
  • Bronchial asthma, or tendency to bronchospasm
  • Recent, unexplained fainting

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • Alcohol is not known to affect dipyridamole.

The elderly: dipyridamole can be used in the elderly.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

The safety of dipyridamole has not been established during pregnancy, and therefore use of this medication is not recommended. Ask your doctor or pharmacist if you have any doubts or questions about this.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Dipyridamole is not safe to take if you are breastfeeding

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

DIPYRIDAMOLE INTERACTIONS

Before using this medicine, tell your prescriber of all the medicines you are taking including prescription medicines and medicines you have bought over the counter without a prescription. Tell your prescriber if you are taking vitamins or complementary remedies such as herbal products, as these can also interact with medicines.

If you are taking more than one medicine, these may interact with each other. Your prescriber may decide to use medicines which interact with each other if the benefit outweighs the risks. In these cases, the dose of your medicines may need to be adjusted or you may be monitored more closely.

The following medicines may interact with dipyridamol:

  • Aspirin
  • Medicines to lower blood pressure
  • Cholinesterase inhibitors (for muscle weakness)
  • Adenosine (for heart problems or heart tests)
  • Medicines to prevent blood clotting (anti-coagulants), such as warfarin
  • Antacids (for indigestion)
  • Xanthine derivatives, such as caffeine and theophylline which should be avoided 24 hours before medication in the ampoule form for myocardial imaging.

This information does not contain all possible interactions. Therefore, tell your prescriber of all the products you are using before taking this medicine.

If you have a question or want to discuss anything about your medicine, speak to your local pharmacist.

DIPYRIDAMOLE OVERDOSE

Overdose symptoms may include: warm feeling, flushes, sweating, restlessness, feeling of weakness, dizziness and chest pain. A drop in blood pressure and increase in heart rate might be observed.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of dipyridamole or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

Injections are given under the direction of a doctor and hence overdose is very unlikely.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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