Aspirin/Dipyridamole

DEA Class;  Rx

Common Brand Names; Aggrenox

Antiplatelet Agents, Hematologic

Oral antiplatelet combination of aspirin and dipyridamole

Indicated secondary stroke prophylaxis in adult patients who have had a transient ischemic attack (TIA) or ischemic stroke due to thrombosis

Not a substitute for low-dose aspirin therapy in stroke or TIA patients who also need aspirin for cardiac indications.

Indicated for Secondary prophylaxis of transient ischemic attack (TIA) or cerebrovascular accident (CVA)

Hypersensitivity to aspirin, dipyridamole, or NSAIDs

Syndrome of asthma, rhinitis, and nasal polyps

Children younger than 16 years with viral infections (risk of Reye syndrome)

>10%

Headache (10-39%)

Dyspepsia (4-18%)

Abdominal pain (4-18%)

Nausea (6-16%)

Diarrhea (13%)

1-10%

Vomiting (3-8%)

Pain (6%)

Fatigue (6%)

Arthralgia (5%)

Back pain (5%)

Hemorrhage, nonspecific (3%)

Accidental injury (3%)

Discontinue if tinnitus or impaired hearing occurs

Use with caution in patients with cardiovascular or GI diseases or bleeding disorders

Avoid use in patients with history of peptic ulcer disease

Risk of precipitation of chest pain in patients with underlying coronary artery disease (CAD)

Dosage in drug may not be adequate in patients with history of stroke or TIA for whom aspirin is indicated to prevent recurrent MI or angina pectoris

Preexisting hypotension may be exacerbated by peripheral vasodilation

Increased bleeding risk when drug coadministered with antiplatelet agents (eg, anagrelide), anticoagulants (eg, heparin), fibrinolytic agents, or NSAIDs (in long-term use)

When possible, surgical patients should not receive aspirin 2 weeks before undergoing a surgical procedure

Risk of elevated liver function test values or hepatic failure with dipyridamole administration

Intake of drug within 48 hours prior to stress testing with intravenous dipyridamole or other adenosinergic agents may increase risk for cardiovascular side effects of and may impair sensitivity of test

Pregnancy 

Available data from published studies and postmarketing experience with use during pregnancy have not identified clear association between drug use and major birth defects, miscarriage, or adverse maternal or fetal outcomes drug combination contains low-dose aspirin which is an NSAID

Increases risk for bleeding; maternal use of high-dose aspirin can result in excessive blood loss at delivery, prolonged gestation, prolonged labor, intracranial hemorrhage in premature infants, low birth weight, stillbirth, and neonatal death

Lactation: Based on data from a clinical lactation study in breastfeeding women taking low-dose aspirin, the metabolite salicylic acid is present in human milk in low levels; dipyridamole is also present in human milk; there is no information on the effects of drug combination components on breastfed infant or on milk production; there is insufficient information to determine effects of aspirin on breastfed infant and no information on effects of aspirin on milk production

Adults

50 mg/day PO aspirin and 400 mg/day PO dipyridamole.

Geriatric

50 mg/day PO aspirin and 400 mg/day PO dipyridamole.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

CApsule, extended release

25mg/200mg