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Antiplatelet (phosphodiesterase inhibitor + adenosine reuptake inhibitor)

Dipyridamole

Brand names: Persantin, Persantin Retard, Asasantin Retard (with aspirin)

Dipyridamole is an antiplatelet agent used, typically in combination with aspirin, for secondary prevention after ischaemic stroke or transient ischaemic attack (TIA). A modified-release formulation is used for stroke prevention.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Adjunctive Use in Prophylaxis of Thromboembolism after Cardiac Valve Replacement The recommended dose is 75 to 100 mg four times daily as an adjunct to the usual warfarin therapy. Please note that aspirin is not to be administered concomitantly with coumarin anticoagulants.

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2023-09-16. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits platelet aggregation (through effects on adenosine uptake and phosphodiesterase) and acts as a vasodilator. These actions underlie both its antiplatelet effect and its common adverse effects.

Prescribing in practice

  • Headache is very common when starting, reflecting its vasodilator action — it often limits tolerance but usually settles with continued use; introducing the modified-release form can help.
  • Vasodilatation can cause flushing, dizziness and hypotension; use with caution in unstable angina, recent myocardial infarction, severe coronary artery disease and aortic stenosis.
  • It may potentiate other antiplatelet and anticoagulant drugs (increasing bleeding risk); the modified-release preparation should be used for the stroke-prevention indication.

Monitoring

Largely a clinical review: monitor tolerability (especially headache early on), blood pressure and any signs of bleeding when combined with other antithrombotic drugs. Reassess if symptoms are not tolerated or if there are breakthrough vascular events.

Counselling the patient

  • Headache is common in the first days or weeks and usually eases — continue the medicine and tell us if it is severe or persistent.
  • Dizziness or flushing can occur; rise slowly from sitting or lying.
  • Report any unusual bruising or bleeding, particularly if you also take aspirin or other blood-thinning medicines.

Evidence & guidelines

Antiplatelet therapy is guideline-recommended for secondary prevention after ischaemic stroke/TIA (NICE NG128).

Reference: SmPC Persantin Retard / Asasantin Retard; NICE TA210 (2010); ESPS-2 J Neurol Sci 1996; 143:1; PRoFESS NEJM 2008; 359:1238; ESO Stroke Guidelines 2022; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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