Aspirin + Dipyridamole
Find more information about this combination medication at the webpages for dipyridamole and aspirin
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Drug Status
Government Approvals
None
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
Nonsteroidal Anti-inflammatory Drug and Platelet Aggregation Inhibitor
Controlled Drug Substance
NO
Summary
Aspirin and dipyridamole are used to prevent strokes, which are brain injuries caused by interrupted blood flow, in people who have had transient ischemic attacks, which are brief strokes. They also help reduce the risk of heart attacks, which occur when blood flow to the heart is blocked, and other cardiovascular events, which are problems related to the heart and blood vessels.
Aspirin works by stopping platelets, which are small blood cells, from clumping together, reducing blood clots. Dipyridamole helps widen blood vessels, which are tubes that carry blood, and prevents platelets from sticking together. Together, they enhance each other's effects, providing a comprehensive approach to preventing blood clots and reducing the risk of stroke and other cardiovascular events.
The usual adult dose for aspirin when used with dipyridamole is 25 mg of aspirin and 200 mg of dipyridamole, taken twice daily. This combination is designed to provide the benefits of both medications while minimizing side effects. It's important to follow the prescribed dosage and not adjust the dose without consulting a healthcare provider.
Common side effects of aspirin include stomach upset and increased bleeding risk. Dipyridamole may cause headaches and dizziness. Both medicines can lead to gastrointestinal issues, such as nausea or indigestion. Significant adverse effects include the risk of bleeding, especially in the stomach or brain, due to aspirin's blood-thinning properties. Monitoring for these side effects is crucial.
Aspirin and dipyridamole should not be used by individuals with bleeding disorders, such as hemophilia, or active ulcers due to increased bleeding risk. Aspirin is contraindicated in children with viral infections due to Reye's syndrome, which is a serious condition. Pregnant women should avoid aspirin, especially in the third trimester, due to risks like bleeding and delayed labor.
Indications and Purpose
How does combination of Aspirin and Dipyridamole work?
Aspirin and dipyridamole work together to prevent blood clots by inhibiting platelet aggregation. Aspirin achieves this by irreversibly inhibiting the enzyme cyclooxygenase, which reduces the production of thromboxane A2, a molecule that promotes platelet aggregation. Dipyridamole complements this action by inhibiting the uptake of adenosine into platelets, leading to increased levels of cyclic AMP, which further inhibits platelet function. This dual mechanism provides a comprehensive approach to reducing the risk of stroke.
How effective is combination of Aspirin and Dipyridamole?
The effectiveness of aspirin and dipyridamole in reducing the risk of stroke has been demonstrated in clinical trials such as the European Stroke Prevention Study-2 (ESPS2). This study showed that the combination reduced the risk of stroke by 36.8% compared to placebo, and by 22.1% compared to aspirin alone. Aspirin provides immediate antiplatelet effects, while dipyridamole offers sustained action through its extended-release formulation, together providing a comprehensive approach to stroke prevention.
Directions for Use
What is the usual dose of combination of Aspirin and Dipyridamole?
The usual adult daily dose for the combination of aspirin and dipyridamole is one capsule taken twice daily, once in the morning and once in the evening. Each capsule contains 25 mg of aspirin and 200 mg of extended-release dipyridamole. This dosing regimen ensures that the antiplatelet effects of both medicines are maintained throughout the day, with aspirin providing immediate platelet inhibition and dipyridamole offering prolonged action due to its extended-release formulation.
How does one take combination of Aspirin and Dipyridamole?
Aspirin and dipyridamole capsules should be taken twice daily, once in the morning and once in the evening, and can be taken with or without food. The capsules should be swallowed whole and not crushed or chewed. There are no specific food restrictions, but patients should be cautious with alcohol consumption, as it can increase the risk of bleeding. It's important to follow the prescribed regimen and consult a healthcare provider if there are any concerns.
For how long is combination of Aspirin and Dipyridamole taken?
Aspirin and dipyridamole are typically used long-term to reduce the risk of stroke in patients with a history of transient ischemic attacks or ischemic strokes. The duration of use is generally indefinite, as long as the patient continues to be at risk for stroke and can tolerate the medication. Regular follow-ups with a healthcare provider are necessary to monitor the effectiveness and any potential side effects of the treatment.
How long does it take for combination of Aspirin and Dipyridamole to work?
Aspirin and dipyridamole work together to prevent blood clots, which can reduce the risk of stroke. Aspirin acts quickly to inhibit platelet aggregation, with effects starting within 30 minutes to an hour after ingestion. Dipyridamole, on the other hand, has a slower onset as it is an extended-release formulation, reaching peak plasma levels approximately 2 hours after administration. The combination of these two medicines provides a balanced approach to reducing stroke risk, with aspirin providing immediate action and dipyridamole offering sustained effects.
Warnings and Precautions
Are there harms and risks from taking combination of Aspirin and Dipyridamole?
Common side effects of aspirin and dipyridamole include headache, heartburn, stomach pain, nausea, vomiting, diarrhea, and muscle and joint pain. Significant adverse effects can include bleeding, severe rash, swelling of the lips, tongue, or mouth, difficulty breathing, and chest pain. Patients should be aware of these potential side effects and contact their healthcare provider if they experience any severe or persistent symptoms.
Can I take combination of Aspirin and Dipyridamole with other prescription drugs?
Aspirin and dipyridamole can interact with several prescription drugs, increasing the risk of bleeding. These include anticoagulants like warfarin and heparin, other antiplatelet agents, and NSAIDs. Additionally, aspirin can affect the efficacy of ACE inhibitors and beta-blockers, while dipyridamole can interact with adenosinergic agents used in stress testing. Patients should inform their healthcare provider of all medications they are taking to avoid potential interactions.
Can I take combination of Aspirin and Dipyridamole if I am pregnant?
Aspirin and dipyridamole should be used with caution during pregnancy, particularly after 20 weeks, due to the risk of fetal harm and complications during delivery. Aspirin, an NSAID, can cause issues such as prolonged labor and bleeding in the mother and fetus. There is limited data on the effects of dipyridamole during pregnancy, but it is generally advised to use this combination only if the potential benefits justify the risks. Pregnant women should consult their healthcare provider before using this medication.
Can I take combination of Aspirin and Dipyridamole while breastfeeding?
During lactation, aspirin and dipyridamole can pass into breast milk. While low levels of salicylic acid, a metabolite of aspirin, have been detected in breast milk, the effects on the breastfed infant are not well-documented. Dipyridamole is also present in breast milk, but its impact on the infant is unclear. Breastfeeding mothers should discuss the risks and benefits with their healthcare provider to determine the best course of action.
Who should avoid taking combination of Aspirin and Dipyridamole?
Important warnings for aspirin and dipyridamole include the risk of bleeding, especially in patients taking other anticoagulants or with a history of bleeding disorders. It is contraindicated in individuals with known allergies to NSAIDs, aspirin, or dipyridamole, and in those with asthma, rhinitis, and nasal polyps. Patients with severe liver or kidney dysfunction should avoid this medication. Pregnant women, especially after 20 weeks, should use it only if clearly needed and under medical supervision.
