Drug reference

Dipyridamole

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 154, 155

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Secondary prevention of ischaemic stroke (not associated with atrial fibrillation) and transient ischaemic attacks (used alone or with aspirin) | Adjunct to oral anticoagulation for prophylaxis of thromboembolism associated with prosthetic heart valves ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: 200 mg twice daily, to be taken preferably with food Adjunct to oral anticoagulation for prophylaxis of thromboembolism associated with prosthetic heart valves ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: 300–600 mg daily in 3–4 divided doses Myocardial imaging—diagnostic use only ▶BY INTRAVENOUS INJECTION ▶Adult: (consult product literature)

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Cautions

Aortic stenosis. coagulation disorders. heart failure. hypotension. left ventricular outﬂow obstruction. may exacerbate migraine. myasthenia gravis (risk of exacerbation). rapidly worsening angina. recent myocardial infarction CAUTIONS, FURTHER INFORMATION ▶Elderly Prescription potentially inappropriate (STOPP criteria) with concurrent signiﬁcant bleeding risk, such as uncontrolled severe hypertension, bleeding diathesis or recent non-trivial spontaneous bleeding (high risk of bleeding). See also Prescribing in the elderly p. 33.

PDF pages 154, 155

Prescribing And Dispensing Information

Modiﬁed- release capsules should be dispensed in original container (pack contains a desiccant) and any capsules remaining should be discarded 6 weeks after opening.

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National Funding Access Decisions

NICE decisions ▶Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events (December 2010) NICE TA210 The guidance applies to patients who have had an occlusive vascular event, or who have established peripheral arterial disease. The guidance does not apply to patients who have had, or are at risk of, stroke associated with atrial ﬁbrillation, or who need prophylaxis for occlusive events following coronary revascularisation or carotid artery procedures. Modiﬁed-release dipyridamole, in combination with aspirin, is recommended as an option to prevent occlusive vascular events in patients who have had: . a transient ischaemic attack, or . an ischaemic stroke, only if clopidogrel is contra- indicated or not tolerated. Modiﬁed-release dipyridamole monotherapy is recommended as an option to prevent occlusive vascular events in patients who have had: . an ischaemic stroke, only if aspirin and clopidogrel are contra-indicated or not tolerated, or . a transient ischaemic attack, only if aspirin is contra- indicated or not tolerated. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta210

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Safety

Interactions

→Appendix 1: dipyridamole

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Side Effects

GENERAL SIDE-EFFECTS ▶Common or very common Angina pectoris. diarrhoea. dizziness. headache. hot ﬂush. hypotension. myalgia. nausea. skin reactions. vomiting ▶Frequency not known Angioedema SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With intravenous use Arrhythmias. paraesthesia ▶Uncommon ▶With intravenous use Abdominal pain. respiratory disorders ▶Rare or very rare ▶With intravenous use Cardiac arrest. cardiac death. cerebrovascular insufﬁciency. seizure ▶Frequency not known ▶With intravenous use Atrioventricular block. oedema. syncope ▶With oral use Bronchospasm. haemorrhage. tachycardia. thrombocytopenia

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Pregnancy

Not known to be harmful.

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Breast Feeding

Manufacturers advise use only if essential—small amount present in milk.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Cardiovascular system Oral suspension ▶Dipyridamole (Non-proprietary) Dipyridamole 10 mg per 1 ml Dipyridamole 50mg/5ml oral suspension sugar-free | 150 ml P £39.40 DT = £39.40 Dipyridamole 40 mg per 1 ml Dipyridamole 200mg/5ml oral suspension sugar-free | 150 ml P £133.53 DT = £133.53 Modified-release capsule CAUTIONARY AND ADVISORY LABELS 21, 25 ▶Attia (Dr Reddy’s Laboratories (UK) Ltd) Dipyridamole 200 mg Attia 200mg modified-release capsules | 60 capsule P £13.15 DT = £13.15 ▶Ofcram PR (Advanz Pharma) Dipyridamole 200 mg Ofcram PR 200mg capsules | 60 capsule P £10.06 DT = £13.15 Tablet CAUTIONARY AND ADVISORY LABELS 22 ▶Dipyridamole (Non-proprietary) Dipyridamole 25 mg Dipyridamole 25mg tablets | 84 tablet P £9.20 DT = £8.96 Dipyridamole 100 mg Dipyridamole 100mg tablets | 84 tablet P £12.50 DT = £5.58

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Dose text by age group

Adult

200 mg twice daily, to be taken preferably with

First-line fragment. Read the complete Indications and Dose section above.

PDF page 154

Adult

300–600 mg daily in 3–4 divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 154

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 154

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Dipyridamole

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 154, 155

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 154

Cautions

PDF pages 154, 155

Prescribing And Dispensing Information

Modiﬁed- release capsules should be dispensed in original container (pack contains a desiccant) and any capsules remaining should be discarded 6 weeks after opening.

PDF page 155

National Funding Access Decisions

PDF page 155

Safety

Interactions

→Appendix 1: dipyridamole

PDF page 155

Side Effects

PDF page 155

Pregnancy

Not known to be harmful.

PDF page 155

Breast Feeding

Manufacturers advise use only if essential—small amount present in milk.

PDF page 155

Dose and formulations

Medicinal Forms

PDF page 155

Dose text by age group

Adult

200 mg twice daily, to be taken preferably with

First-line fragment. Read the complete Indications and Dose section above.

PDF page 154

Adult

300–600 mg daily in 3–4 divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 154

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 154

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.