Aspirin and Extended-Release Dipyridamole

(dye peer id' a mole)

Brand Name(s): Aggrenox^® (as a combination product containing Aspirin, Dipyridamole); also available generically

WHY is this medicine prescribed?

The combination of aspirin and extended-release dipyridamole is in a class of drugs called antiplatelet agents. It works by preventing excessive blood clotting. It is used to reduce the risk of stroke in patients who have had or are at risk of stroke.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

The combination of aspirin and extended-release dipyridamole comes as a capsule to take by mouth. It is usually taken twice a day, one capsule in the morning and one in the evening. Aspirin and extended-release dipyridamole should be swallowed whole. Do not open, crush, break, or chew the capsules.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take aspirin and extended-release dipyridamole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

The combination of aspirin and extended-release dipyridamole decreases the risk of having a stroke but does not eliminate that risk. Continue to take aspirin and extended-release dipyridamole even if you feel well. Do not stop taking aspirin and extended-release dipyridamole without talking to your doctor.

What SPECIAL PRECAUTIONS should I follow?

Before taking aspirin and extended-release dipyridamole,

• tell your doctor and pharmacist if you are allergic to aspirin, celecoxib (Celebrex), choline salicylate (Arthropan), diclofenac (Cataflam), diflunisal (Dolobid), dipyridamole (Persantine), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin, Nuprin), indomethacin (Indocin), ketoprofen (Orudis, Oruvail), ketorolac (Toradol), magnesium salicylate (Nuprin Backache, Doan's), meclofenamate, mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), oxaprozin (Daypro), piroxicam (Feldene), rofecoxib (Vioxx) (no longer available in the US), sulindac (Clinoril), tolmetin (Tolectin), or any other drugs.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetazolamide (Diamox); ambenonium (Mytelase); angiotensin-converting enzyme inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); anticoagulants ('blood thinners') such as warfarin (Coumadin) and heparin; beta-blockers such as acebutolol (Sectral), atenolol (Tenormin), betaxolol (Kerlone), bisoprolol (Zebeta), carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne), metoprolol (Lopressor), nadolol (Corgard), penbutolol (Levatol), pindolol (Visken), propranolol (Inderal), sotalol (Betapace), and timolol (Blocadren); diabetes medications such as acetohexamide (Dymelor), chlorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (DiaBeta, Micronase, Glynase), repaglinide (Prandin), tolazamide (Tolinase), and tolbutamide (Orinase); diuretics ('water pills') such as amiloride (Midamor), bumetanide (Bumex), chlorothiazide (Diuril), chlorthalidone (Hygroton), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Hydrodiuril), indapamide (Lozol), metolazone (Zaroxolyn), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium); methotrexate (Folex, Mexate, Rheumatrex); neostigmine (Prostigmin); nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib (Celebrex), choline salicylate (Arthropan), diclofenac (Cataflam), diflunisal (Dolobid), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), ketoprofen (Orudis, Oruvail), ketorolac (Toradol), magnesium salicylate (Nuprin Backache, Doan's), meclofenamate, mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin); phenytoin (Dilantin); probenecid (Benemid); pyridostigmine (Mestinon); sulfinpyrazone (Anturane); and valproic acid and related drugs (Depakene, Depakote).

• tell your doctor if you have or have ever had liver, kidney, or heart disease; a recent heart attack; bleeding disorders; low blood pressure; vitamin K deficiency; ulcers; the syndrome of asthma, rhinitis, and nasal polyps; or if you drink three or more alcoholic drinks a day.

• tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Aspirin may harm the fetus and cause problems with delivery if it is taken around 20 weeks or later during pregnancy. Do not take aspirin and extended-release dipyridamole around or after 20 weeks of pregnancy, unless you are told to do so by your doctor. If you become pregnant while taking aspirin and extended-release dipyridamole, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet while taking aspirin and extended-release dipyridamole.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Side effects from aspirin and extended-release dipyridamole can occur. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• heartburn
• stomach pain
• nausea
• vomiting
• diarrhea
• muscle and joint pain
• tiredness

If you experience any of the following symptoms, call your doctor immediately:

• bleeding
• severe rash
• swelling of the lips, tongue, or mouth
• difficulty breathing
• warm feeling
• flushing
• sweating
• restlessness
• weakness
• dizziness
• chest pain
• rapid heartbeat
• ringing in the ears

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Do not substitute the individual components of aspirin and dipyridamole (Persantine) for the combination product of aspirin and extended-release dipyridamole.

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to aspirin and extended-release dipyridamole.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: August 15, 2023.