This combination antiplatelet therapy is indicated for reducing the risk of stroke in patients who have experienced transient cerebral ischemia or a completed ischemic stroke due to thrombosis.

This formulation contains a combination of antiplatelet agents, aspirin and dipyridamole, intended for oral use. Aspirin inhibits platelet aggregation by irreversibly blocking platelet cyclooxygenase, thereby reducing the formation of thromboxane A2. Dipyridamole reduces platelet aggregation by inhibiting the uptake of adenosine into platelets, which enhances its vasodilatory effect. It also increases intracellular cAMP levels, leading to reduced calcium concentration and inhibition of platelet aggregation. Additionally, dipyridamole inhibits phosphodiesterase (PDE), particularly cGMP-PDE, resulting in increased levels of cGMP mediated by endothelium-derived relaxing factor (nitric oxide), a potent vasodilator.

The recommended dose is one capsule given orally twice daily. One in the morning and one in the evening. Capsules should be swallowed whole without chewing. This can be administered with or without food.

Pediatric Use: The safety and effectiveness of this capsule in pediatric patients have not been studied. So, the use of this preparation in the pediatric population is not recommended.

Concurrent use with anticoagulants, antiplatelet agents, or NSAIDs may increase the risk of bleeding. Reduced renal function may occur when used together with NSAIDs, beta-blockers, or diuretics. Dipyridamole may interfere with the anticholinesterase effects of cholinesterase inhibitors, potentially worsening myasthenia gravis.

Hypersensitivity: This product is contraindicated in patients with known hypersensitivity to any of its components.
Allergy: Aspirin should not be used in patients allergic to nonsteroidal anti-inflammatory drugs (NSAIDs) or in those with asthma, rhinitis, or nasal polyps. It may cause severe urticaria, angioedema, or bronchospasm.
Reye’s Syndrome: Aspirin must not be used in children or adolescents with viral infections due to the risk of Reye’s syndrome.

Commonly reported adverse effects include headache, dyspepsia, abdominal pain, nausea, and diarrhoea.

Aspirin use during pregnancy may cause excessive bleeding during delivery, prolonged gestation, and delayed labor. Therefore, this drug should be avoided during the last trimester of pregnancy and during labor. Both dipyridamole and aspirin are excreted in breast milk, so it should not be used in nursing mothers.

This combination is not interchangeable with the individual components of aspirin and dipyridamole. It may increase the risk of intracranial hemorrhage and gastrointestinal bleeding. Caution is advised in patients with peptic ulcer disease, coronary artery disease, hypotension, severe renal impairment, or hepatic insufficiency.

Overdose is typically characterized by combined effects of dipyridamole and aspirin toxicity. Dipyridamole overdose may present with flushing, sweating, restlessness, weakness, dizziness, hypotension, and tachycardia. Aspirin overdose may cause tinnitus, hyperthermia, and hypovolemia. Management includes supportive care, correction of acid-base imbalance, gastric lavage if appropriate, and maintenance of fluid and electrolyte balance. Intravenous glucose may be required for hypoglycemia. Xanthine derivatives (e.g., aminophylline) may help reverse dipyridamole-induced hemodynamic effects.

Antiplatelet drugs

Store in a cool and dry place. Protect from light. Keep out of the reach of children.