Persantine


Persantine

 [per-san´tēn] trademark for preparations of dipyridamole, a coronary vasodilator used to prevent clotting associated with mechanical heart valves and as an adjunct in radionuclide myocardial perfusion imaging.

dipyridamole

Apo-Dipyridamole FC (CA), Apo-Dipyridamole SC (CA), Persantin (UK), Persantine

Pharmacologic class: Platelet adhesion inhibitor

Therapeutic class: Antiplatelet agent, diagnostic agent (coronary vasodilator)

Pregnancy risk category B

Action

Unclear. May reduce platelet aggregation by inhibiting phosphodiesterase, adenosine uptake, or formation of thromboxane A2.

Availability

Tablets: 25 mg, 50 mg, 75 mg

Indications and dosages

To prevent thromboembolism in patients with prosthetic heart valves

Adults: 75 to 100 mg P.O. q.i.d.

Off-label uses

• Prevention of myocardial reinfarction (given with aspirin)

• Thrombotic thrombocytopenia purpura

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:

• hypotension, hepatic insufficiency, severe coronary artery disease

• pregnant or breastfeeding patients

• children younger than age 12 (safety not established).

Administration

• Know that drug is usually given with warfarin when used to prevent thromboembolism.

• Give with a full glass of water at least 1 hour before or 2 hours after meals. If gastric distress occurs, give with food.

Adverse reactions

CNS: dizziness, headache

CV: hypotension

GI: abdominal distress

Hepatic: hepatic failure

Skin: rash

Interactions

Drug-drug. Adenosine: increased adenosine plasma level and CV effects

Cholinesterase inhibitors: counteracts activity of cholinesterase inhibitors

Drug-diagnostic tests. Hepatic enzymes: increased levels

Drug-behaviors. Alcohol use: increased risk of hypotension

Patient monitoring

• Monitor for therapeutic efficacy, including improved exercise tolerance and decreased need for nitrates.

• Assess platelet and coagulation studies regularly.

• Monitor ECG and vital signs, especially blood pressure.

• Monitor hepatic function tests regularly.

Patient teaching

• Advise patient to take drug 1 hour before or 2 hours after meals for best absorption.

See Instruct patient to immediately report unusual tiredness, chest pain or other cardiac symptoms, upper right abdominal pain, yellowing of skin or eyes, or dark urine.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

Persantine®

Cardiology A formulation of dipyridamole used as an alternative to exercise in thallium myocardial perfusion imaging for evaluating CAD in Pts who cannot exercise adequately. See Exercise stress test.