DrugindexOnline^{2nd edition}

Some commonly used brand names are:

In the U.S.—

• Aggrenox

In Canada—

• Aggrenox

Other commonly used names are

Aspirin:

acetylsalicylic acidASAsalicylic acid acetate

Category

• Platelet aggregation inhibitor

Description

Dipyridamole (dye-peer-ID-a-mole) and aspirin (AS-pir-in) is used to lessen the chance of stroke that may occur when a blood vessel in the brain is blocked by blood clots. It is given only when there is a larger-than-usual chance that these problems may occur. For example, it is given to people who have had a stroke, because dangerous blood clots are especially likely to occur in these patients. Dipyridamole and aspirin work by helping to prevent dangerous blood clots from forming.

This medicine is available only with your doctor's prescription, in the following dosage forms:

• Oral
• Capsule (extended-release dipyridamole and immediate-release aspirin ) (U.S.and Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dipyridamole and aspirin the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to dipyridamole, aspirin, or inflammation or pain medicine (excluding narcotics). Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—

• Dipyridamole —Dipyridamole has not been studied in pregnant women. However, dipyridamole has not been shown to cause birth defects or other problems in animal studies.
• Aspirin —Aspirin has been shown to cause bleeding problems in mother and fetus in humans, especially during the last 3 months of pregnancy. Be sure you have discussed this with your doctor.

Breast-feeding—Dipyridamole and aspirin are passed into breast milk in small amount. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—

• Dipyridamole —There is no specific information comparing use of dipyridamole in children with use in other age groups.
• Aspirin —Do not give aspirin to a child or a teenager with a fever or other symptoms of a virus infection, especially flu or chickenpox, without first discussing its use with your child's doctor . This is very important because salicylates may cause a serious illness called Reye's syndrome in children and teenagers caused by a virus infection, especially flu or chickenpox.

Older adults—

• Dipyridamole —Dipyridamole has not been studied specifically in older people taking the medicine regularly to prevent blood clots from forming. Although there is no specific information comparing this use of dipyridamole in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than it does in younger adults.
• Aspirin —Elderly people are especially sensitive to the effects of aspirin. However, this is not expected to limit the usefulness of this drug.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dipyridamole and aspirin, it is especially important that your health care professional know if you are taking any of the following:

• Probenecid (e.g. Benemid) or
• Sulfinpyrazone (e.g. Anturane)—may decrease the effects of these drugs

• Methotrexate (e.g. Rheumatrex)—may increase the toxicity of methotrexate, especially in older people with kidney disease

• Anticoagulants (blood thinners) such as heparin (e.g., Liquaemin) or
• Warfarin (e.g. Coumadin) or
• Inflammation or pain medicines, except narcotics—may increase the chance of bleeding

Other medical problems—The presence of other medical problems may affect the use of dipyridamole and aspirin. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol use, chronic or
• Vitamin K deficiency or other bleeding problems—The chance of bleeding may be increased

• Asthma, allergies, and nasal polyps (history of) or
• Heart disease or
• Liver disease or
• Low blood pressure—The side effects may be increased

• Glucose-6-phosphate dehydrogenase enzyme deficiency—This condition may worsen, increasing risk of anemia

• Gout—The medicine used to treat this condition may not work properly

• Kidney disease—This condition may be made worse

• Stomach inflammation or ulcer—These conditions may worsen, increasing the risk of bleeding

Proper Use of This Medicine

The capsules must be swallowed whole. Do not chew them, crush them or break them up before taking.

Dosing—The dose of dipyridamole and aspirin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of dipyridamole and aspirin. If your dose is different, do not change it unless your doctor tells you to do so.

• For preventing stroke:
  • For oral dosage form (capsules):
    • Adults—The usual dose is one capsule twice a day, one in the morning and one in the evening.
    • Children—Use is not recommended.

Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Dipyridamole and aspirin combination provide better protection against the formation of blood clots than either of the medicines used alone. However, the risk of bleeding may also be increased. To reduce the risk of bleeding:

• Do not take aspirin, or any combination medicine containing aspirin in addition to this medicine unless the same doctor who directed you to take dipyridamole and aspirin also directs you to take aspirin .
• If you need a medicine to relieve pain or a fever, your doctor may not want you to take extra aspirin. It is a good idea to discuss this with your doctor, so that you will know ahead of time what medicine to take.
• Your doctor should check your progress at regular visits.

Tell all medical doctors and dentists you go to that you are taking dipyridamole and aspirin .

Dizziness, lightheadedness, or fainting may occur , especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Do not stop taking this medicine for any reason without first checking with the doctor who directed you to take it.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 05/02/2000
Revised: 02/21/2001

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