Aspirin and dipyridamole

Name: Aspirin and dipyridamole

What should I discuss with my healthcare provider before taking aspirin and dipyridamole?

You should not use this medicine if you are allergic to aspirin or dipyridamole, or if you have:

  • asthma;

  • polyps in your nose; or

  • a history of asthma attack or severe allergic reaction after taking aspirin or an NSAID (nonsteroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

Do not give this medicine to a child or teenager with a fever, flu symptoms, or chicken pox. Aspirin can cause Reye's syndrome, a serious and sometimes fatal condition in children.

To make sure aspirin and dipyridamole is safe for you, tell your doctor if you have:

  • a history of stomach ulcers or bleeding;

  • a bleeding or blood clotting disorder such as hemophilia;

  • heart disease, congestive heart failure;

  • coronary artery disease (hardened arteries);

  • liver disease;

  • kidney disease;

  • low blood pressure; or

  • myasthenia gravis.

Taking aspirin during late pregnancy may cause bleeding in the mother or the baby during delivery. Tell your doctor if you are pregnant or plan to become pregnant while taking aspirin and dipyridamole.

Aspirin and dipyridamole can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

What should I avoid while taking aspirin and dipyridamole?

Drinking alcohol while taking this medicine can increase your risk of bleeding.

Ask a doctor or pharmacist before using any cold, allergy, or pain medication. Many medicines available over the counter contain aspirin, salicylates, or NSAIDs. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, naproxen, magnesium and/or choline salicylate.

What are some things I need to know or do while I take Aspirin and Dipyridamole?

  • Tell all of your health care providers that you take aspirin and dipyridamole. This includes your doctors, nurses, pharmacists, and dentists.
  • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
  • Talk with your doctor before you drink alcohol.
  • This medicine may raise the chance of ulcers or bleeding from the stomach or bowel. Talk with the doctor.
  • You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
  • If you are taking aspirin to help prevent a heart attack, talk with your doctor.
  • If you are 65 or older, use this medicine with care. You could have more side effects.
  • This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking aspirin and dipyridamole, call your doctor right away.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Index Terms

  • Aspirin and Extended-Release Dipyridamole
  • Aspirin/Dipyridamole
  • Dipyridamole and Aspirin

Dosing Hepatic Impairment

Mild to moderate hepatic impairment: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied).

Severe hepatic impairment: Avoid use.

Storage

Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from excessive moisture.

Warnings/Precautions

Concerns related to adverse effects:

• Bleeding: Aspirin may increase the risk of bleeding; risk factors include the use of other drugs that increase the risk of bleeding (eg, anticoagulants, antiplatelet agents, heparin, fibrinolytic therapy, chronic use of NSAIDs). Use with caution in patients with acquired or inherited platelet and bleeding disorders; monitor for signs and symptoms of GI ulcers and bleeding. Use in active GI ulcer or bleeding disorders is contraindicated in the Canadian labeling.

• GI effects: Stomach pain, heartburn, nausea, vomiting, and GI bleeding may occur. Avoid use in patients with a history of active peptic ulcer disease. Use with caution in patients with erosive gastritis or peptic ulcer disease.

• Hepatic effects: Elevated hepatic enzymes and hepatic failure have been reported with dipyridamole.

• Salicylate sensitivity: Patients with sensitivity to tartrazine dyes, nasal polyps, and asthma may have an increased risk of salicylate sensitivity.

• Tinnitus: Discontinue use if tinnitus or impaired hearing occurs.

Disease-related concerns:

• Cardiovascular disease: Dipyridamole produces peripheral vasodilation; may exacerbate preexisting hypotension and/or chest pain in patients with coronary artery disease. Use with caution in patients with hypotension, unstable angina, and/or recent MI; discontinue use 24 hours prior to pharmacologic (IV dipyridamole) stress testing; Note: Amount of aspirin provided may not be adequate for cardiac indications (eg, angina pectoris, MI prophylaxis).

• Ethanol use: Heavy ethanol use (>3 drinks/day) may increase bleeding risk and may enhance gastric mucosal irritation and bleeding.

• Hepatic impairment: Avoid use in severe hepatic impairment.

• Renal impairment: Use with caution in patients with renal impairment (GFR ≥10 mL/minute); avoid use in severe impairment (GFR <10 mL/minute).

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Special populations:

• Pediatric: Avoid use in children due to risk of Reye syndrome associated with aspirin component.

• Surgical patients: ASA should be avoided (if possible) in surgical patients for 1 to 2 weeks prior to surgery, to reduce the risk of excessive bleeding. Consider risk versus benefit when discontinuing prior to surgery.

Dosage form specific issues:

• Interchangeability: Aspirin/dipyridamole combination product is not interchangeable with the individual components of aspirin and dipyridamole.

• Lactose/sucrose: Formulation may contain lactose and/or sucrose; use in patients with fructose and/or galactose intolerance is contraindicated in the Canadian labeling.

In Summary

Commonly reported side effects of aspirin/dipyridamole include: abdominal pain, diarrhea, and headache. See below for a comprehensive list of adverse effects.

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