Aggreno Capsule
Aspirin + Dipyridamole
25mg + 200mg
Ziska Pharmaceuticals Ltd.
| Pack size | 40's Pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 12.00 AED |
Indications
Aggreno Capsule is used for:
Secondary prophylaxis of transient ischemic attack (TIA), cerebrovascular accident (CVA)
Adult Dose
Stroke
Secondary prophylaxis of transient ischemic attack (TIA) or cerebrovascular accident (CVA)
Adult:
One capsule twice daily (morning and evening)
Child Dose
Renal Dose
Renal impairment:
CrCl (ml/min) <10: Avoid.
Administration
May be taken with or without food. Swallow whole, do not chew/crush.
Contra Indications
Hypersensitivity to aspirin, dipyridamole, or NSAIDs
Syndrome of asthma, rhinitis, and nasal polyps
Children younger than 16 years with viral infections (risk of Reye syndrome)
Precautions
Aspirin + Dipyridamole increases the risk of bleeding
Avoid use in patients with severe hepatic or renal insufficiency
Can cause fetal harm when administered to a pregnant woman, especially in the third trimester
Discontinue if tinnitus or impaired hearing occurs
Use with caution in patients with cardiovascular or GI diseases or bleeding disorders
Avoid use in patients with history of peptic ulcer disease
Risk of precipitation of chest pain in patients with underlying coronary artery disease (CAD)
Dosage in drug may not be adequate in patients with history of stroke or TIA for whom aspirin is indicated to prevent recurrent MI or angina pectoris
Preexisting hypotension may be exacerbated by peripheral vasodilation
Increased bleeding risk when drug coadministered with antiplatelet agents (eg, anagrelide), anticoagulants (eg, heparin), fibrinolytic agents, or NSAIDs (in long-term use)
When possible, surgical patients should not receive aspirin 2 weeks before undergoing a surgical procedure
Increased bleeding risk with chronic heavy alcohol use (>3 alcoholic drinks/day)
Risk of elevated liver function test values or hepatic failure with dipyridamole administration
Intake of drug within 48 hours prior to stress testing with intravenous dipyridamole or other adenosinergic agents may increase risk for cardiovascular side effects of and may impair sensitivity of test
Monitoring Parameters
Monitor for signs of ulceration or bleeding, even in the absence of previous GI symptoms.
Pregnancy-Lactation
Pregnancy
Available data from published studies and postmarketing experience with use during pregnancy have not identified clear association between drug use and major birth defects, miscarriage, or adverse maternal or fetal outcomes drug combination contains low-dose aspirin which is an NSAID
Increases risk for bleeding; maternal use of high-dose aspirin can result in excessive blood loss at delivery, prolonged gestation, prolonged labor, intracranial hemorrhage in premature infants, low birth weight, stillbirth, and neonatal death
Animal data
In animal reproduction studies, there were adverse developmental effects with administration of aspirin in rats and rabbits at doses about 66 and 44 times, respectively, the human exposure at maximum recommended daily dose; reproduction studies with dipyridamole in mice, rabbits, and rats have revealed no evidence of harm to fetus up to doses about 25 times maximum recommended daily human dose; nonclinical data are suggestive of possible potentiation of aspirin-related fetal toxicity when combined with dipyridamole
Lactation
Based on data from a clinical lactation study in breastfeeding women taking low-dose aspirin, the metabolite salicylic acid is present in human milk in low levels; dipyridamole is also present in human milk; there is no information on the effects of drug combination components on breastfed infant or on milk production; there is insufficient information to determine effects of aspirin on breastfed infant and no information on effects of aspirin on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition
Interactions
Co-administration with anti-coagulants, antiplatelets, or NSAIDS can increase risk of bleeding
Decreased renal function can occur with co-administration with NSAIDS
Aspirin: May reduce hypotensive and hyponatraemic effects of ACE inhibitors; may increase serum levels and toxicity of acetazolamide; increases anticoagulant effect of heparin, thus increasing bleeding risk; may reduce hypotensive effect of beta-blockers; may reduce efficacy of diuretics in patients with underlying renal or CV disease; salicylate may inhibit renal clearance of methotrexate, thus increasing the risk of bone marrow toxicity; increased risk of bleeding or reduced renal function when used with
NSAIDs; increased risk of hypoglycaemia when used with oral hypoglycaemic drugs; salicylate antagonises the uricosuric effect of uricosuric agents; may increase adverse effect of alendronate.
Dipyridamole: May antagonise the anticholinesterase effect of cholinesterase inhibitors. Increased risk of bleeding when used with warfarin. Antiplatelet effect of aspirin may be increased by antidepressants e.g. TCAs, selective serotonin reuptake inhibitors.
Potentially Fatal: Salicylates may increase adverse effect of drotrecogin alfa. Dypyridamole may increase plasma levels and CV effects of adenosine. Ketorolac may enhance adverse effect of aspirin. Dipyridamole may increase therapeutic effect of regadenoson. Salicylates may increase the anticoagulant effect of vit K antagonists. Salicylates may increase the adverse effect of varicella virus-containing vaccines.
Contraindicated (5)
abrocitinib
dichlorphenamide
riociguat
mifepristone
theophylline
Adverse Effects
Side effects of Aspirin + Dipyridamole :
>10%
Headache (10-39%),Dyspepsia (4-18%),Abdominal pain (4-18%),Nausea (6-16%),Diarrhea (13%)
1-10%
Vomiting (3-8%),Pain (6%),Fatigue (6%),Arthralgia (5%),Back pain (5%),Hemorrhage, nonspecific (3%),Accidental injury (3%),Epistaxis (3%),Amnesia (3%),Arthritis (2%),Melena (2%),Asthenia (2%),Convulsions (2%),Neoplasm, nonspecific (2%),Anemia (2%),Rectal hemorrhage (2%),Malaise (2%),Cardiac failure (2%),Coughing (2%),Purpura (1%),GI hemorrhage (1%),Anorexia (1%),Somnolence (1%)
,Myalgia (1%),Arthrosis (1%),Confusion (1%),Hemorrhoids (1%),Syncope (1%),Upper respiratory tract infection (1%)
Mechanism of Action
Aspirin inhibits platelet aggregation by irreversible inhibition of platelet cyclooxygenase and thus the formation of thromboxane A2 in the platelets.
Dipyridamole inhibits platelet aggregation by preventing the uptake of adenosine into platelets, endothelial cells and RBCs. The combination results in additive antiplatelet effects.
Note
Aggreno 25mg + 200mg Capsule manufactured by Ziska Pharmaceuticals Ltd.. Its generic name is Aspirin + Dipyridamole. Aggreno is availble in Bangladesh.
Farmaco BD drug index information on Aggreno Capsule is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.