Composition
Active ingredients:
dipyridamole 75 mg
Auxiliary substances:
corn starch-33.75 mg,
lactose monohydrate-12.5 mg,
sodium carboxymethyl starch (type A) – 3.75 mg,
gelatin-2.5 mg,
colloidal anhydrous silicon dioxide-1.25 mg,
magnesium stearate-1.25 mg.
Composition of the film shell:
hypromellose-0.9 mg,
talc-0.4 mg,
macrogol 6000-0.12 mg,
titanium dioxide (E 171) – 0.1 mg,
quinoline yellow dye (E 104) – 0.01 mg,
simethicone emulsion-0.002 mg
Pharmacological action
Pharmacodynamics
Vasodilator of myotropic action. It has an inhibitory effect on platelet aggregation, improves microcirculation.
Dipyridamole dilates arterioles in the coronary blood flow system, when taken in high doses – and in other parts of the circulatory system. However, unlike organic nitrates and calcium antagonists, the expansion of larger coronary vessels does not occur.
The vasodilator effect of dipyridamole is due to two different inhibitory mechanisms: suppression of adenosine uptake and inhibition of phosphodiesterase.
In vivo, adenosine is detected at a concentration of approximately 0.15-0.20 mmol. This level is maintained due to the dynamic equilibrium between ejection and re-capture.
Dipyridamole inhibits the uptake of adenosine by endothelial cells, red blood cells and platelets. After use of dipyridamole, an increase in the concentration of adenosine in the blood and an increase in adenosine-related vasodilation are detected. At higher doses, platelet aggregation caused by adenosine is inhibited, and the tendency to clot formation decreases.
The breakdown of cAMP and cGMP, which inhibit platelet aggregation, occurs in platelets under the action of corresponding phosphodiesterases. In high concentrations, dipyridamole inhibits both phosphodiesterases; in therapeutic blood concentrations, it inhibits only cGMP-phosphodiesterase. As a result of stimulation of the corresponding cyclases, the power of cAMP synthesis increases.
As a pyrimidine derivative, dipyridamole is an interferon inducer and has a modulating effect on the functional activity of the interferon system, increases the reduced production of interferon alpha and gamma by blood leukocytes in vitro. The drug increases non-specific resistance to viral infections.
Pharmacokinetics
Suction and distribution
After a single oral dose of 150 mg, the cmax of dipyridamole in plasma averages 2.66 mcg/l and is reached within 1 hour after use.
Dipyridamole binds almost completely to plasma proteins. Dipyridamole accumulates in the heart and in red blood cells.
Metabolism and elimination
Dipyridamole is metabolized in the liver by binding to glucuronic acid. T1 / 2 is 20-30 min. It is excreted in the bile in the form of monoglucuronide.
Indications
- Treatment and prevention of violations of cerebral circulation by ischemic type;
- encephalopathy;
- primary and secondary prevention of CHD, especially in case of intolerance of acetylsalicylic acid;
- prevention of arterial and venous thrombosis and treatment of complications;
- prevention of thromboembolism after surgery for heart valve surgery;
- prevention of placental insufficiency with complicated pregnancy;
- microcirculatory disorders of any type (in the complex therapy);
- prevention and treatment of influenza, SARS (as an inducer of interferon and immunomodulator) – for the drug in a dose of 25 mg.
Use during pregnancy and lactation
It is possible to use the drug during pregnancy according to indications.
The use of the drug during lactation is possible only if the expected benefit of treatment exceeds the possible risk.
Contraindications
- Hypersensitivity to the components of the drug;
- acute myocardial infarction;
- unstable angina;
- common stenosing atherosclerosis of the coronary arteries;
- subaortic stenosis of the aorta;
- heart failure in the stage of decompensation;
- hypotension;
- collapse;
- severe arterial hypertension;
- severe heart rhythm disorders;
- chronic obstructive pulmonary disease;
- chronic renal failure;
- hepatic failure;
- hemorrhagic diathesis;
- diseases with an increased risk of bleeding (including gastric ulcer and duodenal ulcer).
Side effects
From the cardiovascular system: palpitations, tachycardia (especially with the simultaneous use of other vasodilators), bradycardia, flushes of blood to the face, hyperemia of the facial skin, coronary theft syndrome (when using the drug at a dose of more than 225 mg / day), a decrease in blood pressure.
From the digestive system: nausea, vomiting, diarrhea, epigastric pain. Usually, these side effects disappear with prolonged use of the drug.
From the side of the blood coagulation system: thrombocytopenia, changes in the functional properties of platelets, bleeding; in some cases-increased bleeding during or after surgery.
From the central nervous system: dizziness, noise in the head, headache.
Allergic reactions: skin rash, urticaria.
Others: weakness, ear congestion, arthritis, myalgia, rhinitis.
When using the drug in therapeutic doses, side effects are usually insignificant and transient.
Interaction
Concomitant use of Curantyl with anticoagulants or acetylsalicylic acid increases the antithrombotic effect of the latter and, accordingly, the risk of hemorrhagic complications.
When used concomitantly, Curantyl enhances the effect of antihypertensive drugs.
When used together, Curantyl may weaken the anticholinergic effects of cholinesterase inhibitors.
When used concomitantly, xanthine derivatives weaken the vasodilating effect of Curantyl.
How to take, course of use and dosage
The dose of the drug is selected depending on the severity of the disease and the individual response of the patient.
For CHD,75 mg 3 times a day is recommended. If necessary, the daily dose can be increased under the supervision of a doctor.
For the prevention and treatment of cerebral circulatory disorders, as well as for prevention,75 mg is prescribed 3-6 times a day. The maximum daily dose is 450 mg.
To reduce platelet aggregation, Curantyl is prescribed at a dose of 75-225 mg / day in several doses. In severe cases, the dose may be increased to 600 mg / day.
For the prevention of influenza and acute respiratory viral infections, especially during epidemics, Curantyl N25 and Curantyl 25 are prescribed 50 mg each (2 tablets). or 2 pills)/a day in 1 session. The drug is taken once a week for 4-5 weeks.
To prevent relapses of acute respiratory viral infections in patients who often suffer from respiratory viral infections, Curantyl N25 and Curantyl 25 are prescribed 100 mg/day (2 tablets each). or pills 2 times / day with an interval between doses of 2 hours). The drug is taken once a week for 8-10 weeks.
Tablets should be taken on an empty stomach, without breaking or biting, with a small amount of liquid. The duration of treatment is determined by the doctor.
Overdose
Symptoms: decreased blood pressure, angina pectoris, tachycardia, hot flashes, weakness and dizziness.
Treatment: artificial vomiting, gastric lavage, use of activated charcoal. The vasoconstrictor effect of the drug can be stopped by slow (50-100 mg/min) intravenous use of aminophylline. If symptoms of angina persist, nitroglycerin should be administered sublingually.
Special instructions
When drinking tea or coffee at the same time (contain xanthine derivatives) the vasodilating effect of Curantyl may decrease.
Use in pediatrics
Curantyl is not recommended for use in children under 12 years of age due to the lack of sufficient clinical experience with its use.
Influence on the ability to drive vehicles and other mechanisms that require increased concentration of attention
Caution should be exercised when driving vehicles and operating mechanisms, since as a result of a drop in blood pressure against the background of taking Curantyl, the ability to concentrate attention and speed of psychomotor reactions may worsen.
Form of production
Film-coated tablets.
Storage conditions
At a temperature not exceeding 30 °C
Shelf life
3 years
Active ingredient
Dipyridamole
Conditions of release from pharmacies
By prescription
Dosage form
Tablets
Purpose
Adults prescribed by a doctor, Nursing mothers, Children over 12 years of age, Pregnant women prescribed by a doctor, Children prescribed by a doctor
Indications
Cerebrovascular accident, Thrombosis prevention
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Side effects of Curantyl N75, pills 75mg, 40pcs.
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