• PO: Prevention of thromboembolism in patients with prosthetic heart valves (with warfarin).
• Maintains patency after surgical grafting procedures, including coronary artery bypass (with aspirin).
• IV: As an alternative to exercise in myocardial perfusion scintigraphy (cardiac stress testing with radiotracer imaging).

Contraindicated in:

• Hypersensitivity.

Use Cautiously in:

• Hypotension
• Patients with platelet defects
• OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
• Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant
• Pedi: Children <12 yr (safety and effectiveness not established)
• Geri: Appears on Beers list. Older adults may have ↑ risk of orthostatic hypotension with oral, short-acting formulation. Avoid use of oral, short-acting formulation in older adults.

CV: hypotension, arrhythmias, flushing.
IV only: MI.

GI: nausea, diarrhea, GI upset, vomiting.

Derm: rash.

Neuro: dizziness, headache, syncope.
IV only: transient cerebral ischemia, weakness.

Resp: IV only: bronchospasm.

Drug-Drug:

• Additive effects with aspirin on platelet aggregation.
• Risk of bleeding may be ↑ when used with anticoagulants, thrombolytic agents, NSAIDs, cefotetan, or valproic acid.
• ↑risk of hypotension with alcohol.
• Theophylline may negate the effects of dipyridamole during diagnostic thallium imaging.

(Generic available)

• Tablets: 25 mg; 50 mg; 75 mg;
• Solution for injection: 5 mg/mL;
• In combination with: aspirin.

• PO (Adults): 225–400 mg/day in 3–4 divided doses.
• IV (Adults): 570 mcg/kg; maximum dose 60 mg.

Persantine

• PO: Decreases platelet aggregation by inhibiting the enzyme phosphodiesterase.
• IV: Produces coronary vasodilation by inhibiting adenosine uptake.

• PO: Inhibition of platelet aggregation and subsequent thromboembolic events.
• IV: In diagnostic thallium imaging, dipyridamole dilates normal coronary arteries, reducing flow to vessels that are narrowed and causing abnormal thallium distribution.

Therapeutic Classification: antiplatelet agents, diagnostic agents (coronary vasodilators)

Pharmacologic Classification: platelet adhesion inhibitors

Absorption: Moderately absorbed (30–60%) after oral administration. IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Metabolized by the liver; excreted in the bile.

Half-life: 10 hr.

Persantine

(PO = antiplatelet activity, IV = coronary vasodilation)

†From start of infusion.

• PO: Instruct patient to take medication at evenly spaced intervals as directed. Take missed doses as soon as remembered unless the next scheduled dose is within 4 hr. Do not double doses. Benefit of medication may not be apparent to patient; encourage patient to continue taking medication as directed.
  • Caution patient to change positions slowly to minimize orthostatic hypotension.
  • Advise patient to avoid the use of alcohol, as it may potentiate the hypotensive effects. Tobacco products should also be avoided because nicotine causes vasoconstriction.
  • Advise patient to consult health care professional before taking OTC medications concurrently with this medication. Aspirin should be taken only if directed and only in dose prescribed. Advise patient to discuss alternatives for pain relief or fever.
  • Instruct patient to notify health care professional if unusual bleeding or bruising occurs. Concurrent use of aspirin or warfarin may increase risk of bleeding but is commonly used with specific indications.
• Advise patient to notify health care professional of medication regimen and whether using concurrent aspirin or warfarin therapy.
• Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
• IV: Instruct patient to notify health care professional immediately if dyspnea or chest pain occurs.

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