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Dipyridamole 💊
⚠️ Dipyridamole commonly causes headache (due to vasodilation), so start at a low dose if needed. Modified-release (MR) 200 mg BD is preferred in UK practice. Headache usually improves after the first few days.
📖 About
- Antiplatelet and coronary vasodilator agent.
- Often used with aspirin in secondary prevention of TIA and ischaemic stroke, if clopidogrel is unsuitable.
- Also used IV as a vasodilator in myocardial perfusion scanning.
⚙️ Mode of Action
- Inhibits platelet phosphodiesterase → ↑ intracellular cAMP → ↓ platelet aggregation.
- Blocks uptake of adenosine into erythrocytes and endothelium → ↑ extracellular adenosine → vasodilation and further antiplatelet effect.
- Coronary vasodilation can sometimes worsen angina (rare “coronary steal” phenomenon).
🩺 Indications
- Secondary prevention of TIA/ischaemic stroke: usually with aspirin; MR dipyridamole preferred (NICE CG68).
- Additional antiplatelet therapy: e.g., in selected patients post-CABG.
- Diagnostic use: IV dipyridamole in myocardial perfusion scans.
💊 Dosing – Dipyridamole (BNF; verify with local policy)
| Formulation | Details |
|---|---|
| 💊 Standard release | • 100 mg PO QDS |
| 🕒 Modified release |
• 200 mg PO BD
• ✅ Preferred in UK practice |
⚠️ Cautions
- Aortic stenosis.
- Unstable angina, ischaemic heart disease (risk of coronary steal).
- Hypotension.
🚫 Contraindications
- Severe coronary artery disease / unstable angina.
- Severe hypotension.
❗ Side Effects
- Headache (very common, due to vasodilation).
- Flushing, dizziness, nausea, diarrhoea.
- Hypotension, rash.
- Worsening angina (rare).
- Bleeding risk (when used with other antiplatelets).
📚 References
- BNF: Dipyridamole
- NICE CG68: Stroke and TIA management
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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