dipyridamole

CLINICAL USE


Calcium-channel blocker:Prophylaxis and treatment of angina Hypertension

DOSE IN NORMAL RENAL FUNCTION

180–500 mg in up to 3 divided doses

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :451
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :80–85
  • %Excreted unchanged in urine &nbsp &nbsp : 5

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :3–8

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2–11; SR: 5–8/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :Not dialysed. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsAnaesthetics: enhanced hypotensive effect Anti-arrhythmics: increased risk of bradycardia, AV block and myocardial depression with amiodaroneAntibacterials: metabolism increased by rifampicinAnti-epileptics: effect probably reduced by barbiturates, phenytoin, and primidone; enhanced effect of carbamazepine; increased levels of phenytoinAntihypertensives: enhanced hypotensive effect; increased risk of first dose hypotensive effect of post-synaptic alpha-blockersAntivirals: concentration increased by amprenavir, atazanavir and ritonavir – reduce dose of diltiazem with atazanavir; concentration reduced by efavirenzBeta-blockers: risk of bradycardia and AV block if co-prescribed with beta-blockersCardiac glycosides: increased digoxin concentrationCiclosporin: increased ciclosporin concentrationsCilostazol: increased cilostazol concentration – avoid concomitant useIvabradine: avoid concomitant use Sirolimus: sirolimus concentration increasedStatins: increased myopathy with simvastatin. Do not exceed 40 mg of simvastatin with diltiazem.1Tacrolimus: increased tacrolimus concentrationTheophylline: enhanced effect of theophylline

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Active metabolites Monitor heart rate early on in therapy. If falls below 50 beats/minute, do not increase dose Maintain patient on same brand
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