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Aggrenox (Aspirin / Extended-Release Dipyridamole) - Summary

 
 



AGGRENOX SUMMARY

Aggrenox®
(aspirin/extended-release dipyridamole)
25 mg/200 mg capsules

AGGRENOX® (aspirin/extended-release dipyridamole) is a combination antiplatelet agent intended for oral administration. Each hard gelatin capsule contains 200 mg dipyridamole in an extended-release form and 25 mg aspirin, as an immediate-release sugar-coated tablet.

AGGRENOX (aspirin/extended-release dipyridamole) is indicated to reduce the risk of stroke in patients who have had transient ischemia of the brain or completed ischemic stroke due to thrombosis.


See all Aggrenox indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Aggrenox (Aspirin / Dipyridamole)

Deaths from ischemic stroke due to tobacco smoking in China, India and Russia more than for all the world's other countries combined
Source: Smoking / Quit Smoking News From Medical News Today [2014.04.07]
New research published in Global Heart (the journal of the World Heart Federation) shows that deaths from ischaemic stroke (IS) due to tobacco use in China, India, and Russia together are higher than...

Stroke Rounds: Best Ways to Cut tPA Tx Times
Source: MedPage Today Emergency Medicine [2014.04.10]
(MedPage Today) -- The three strategies most strongly associated with reduced times to treatment with tissue plasminogen activator (tPA) in acute ischemic stroke are used at relatively low rates, a survey showed.

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Published Studies Related to Aggrenox (Aspirin / Dipyridamole)

Use of aspirin associates with longer primary patency of hemodialysis grafts. [2011.04]
Extended-release dipyridamole plus low-dose aspirin (ERDP/ASA) prolongs primary unassisted graft patency of newly created hemodialysis arteriovenous grafts, but the individual contributions of each component are unknown. Here, we analyzed whether use of aspirin at baseline associated with primary unassisted graft patency among participants in a randomized trial that compared ERDP/ASA and placebo in newly created grafts.

Effects of Aggrenox and aspirin on plasma endothelial nitric oxide synthase and oxidised low-density lipoproteins in patients after ischaemic stroke. The AGgrenox versus aspirin therapy evaluation (AGATE) biomarker substudy. [2011.01]
Plasma endothelial nitric oxide synthase (eNOS), and oxidised low-density lipoproteins (oxLDL) are established biomarkers of atherosclerosis... In the small randomised study, both aspirin and Aggrenox produced fast and sustained recovery of plasma eNOS levels, while only therapy with Aggrenox was associated with oxLDL inhibition late in the trial.

The Japanese aggrenox (extended-release dipyridamole plus aspirin) stroke prevention versus aspirin programme (JASAP) study: a randomized, double-blind, controlled trial. [2011]
BACKGROUND: Despite improvements in treatment, stroke still carries a high death toll and disability in Asia. Extended-release dipyridamole (ER-DP) plus acetylsalicylic acid (ASA) has consistently been shown to be superior over conventional platelet inhibition by ASA. ER-DP plus ASA is well established in the secondary prevention of stroke in a lot of countries including the USA and Europe. DP has an established benefit in the treatment of heart disease in Japan; however, for the prevention of stroke, the fixed-dose combination of ER-DP plus ASA has only been investigated in a small number of patients in Japan... CONCLUSIONS: The results of the study are inconclusive. Noninferiority of ER-DP plus ASA versus ASA could not be established, a difference between treatments could not be shown for the primary end point. Possible reasons for this result include a small sample size, low event rates and too short a treatment duration (ClinicalTrials. gov number, NCT00311402). Copyright (c) 2011 S. Karger AG, Basel.

Safety of fixed-dose aspirin-extended-release dipyridamole in patients with ischemic heart disease. [2010.05.01]
CONCLUSION: A literature review revealed that fixed-dose aspirin-ER dipyridamole was not associated with an increased risk of cardiovascular events in patients with ischemic heart disease. However, individual patient factors merit consideration when choosing an antiplatelet agent for stroke prevention.

Early treatment with aspirin plus extended-release dipyridamole for transient ischaemic attack or ischaemic stroke within 24 h of symptom onset (EARLY trial): a randomised, open-label, blinded-endpoint trial. [2010.02]
BACKGROUND: Little is known about the best antiplatelet treatment immediately after ischaemic stroke or transient ischaemic attack (TIA). The EARLY trial aimed to compare outcome in patients given aspirin plus extended-release dipyridamole twice daily either within 24 h of stroke or TIA or after 7 days of aspirin monotherapy... INTERPRETATION: Early initiation of aspirin plus extended-release dipyridamole within 24 h of stroke onset is likely to be as safe and effective in preventing disability as is later initiation after 7 days. FUNDING: Boehringer Ingelheim. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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Clinical Trials Related to Aggrenox (Aspirin / Dipyridamole)

JASAP: Japanese Aggrenox Stroke Prevention vs. Aspirin Programme [Active, not recruiting]
Phase III study to compare the preventive effect of recurrent brain infarction and safety of Aggrenox (combination drug containing sustained-release dipyridamole 200 mg/acetylsalicylic acid 25 mg) twice daily vs. acetylsalicylic acid 81 mg once daily

Headache Study to Compare Aggrenox Full Dose and Reduced Dose [Completed]
Tolerability of a four weeks treatment with Aggrenox« modified release capsules b. i.d, compared to reduced dose during the first two weeks of treatment in a double-blind, randomized controlled parallel group comparison trial among Taiwanese patients with previous TIA's or ischemic stroke. To monitor frequency and intensity of headaches and other safety parameters among Taiwanese patients with previous TIA's or ischemic stroke given Aggrenox using a titration scheme or not

EARLY 3-Months Aggrenox Treatment Started Within 24 Hrs of Ischemic Stroke Onset vs. After One Week 100 mg ASA [Recruiting]
German stroke units are hesitating to use Aggrenox for secondary ischaemic stroke / transient ischaemic attack (TIA) prevention in a sub-acute treatment setting. They argue that clinical experience with sub-acute Aggrenox treatment is limited and poorly documented when compared with sub-acute acetylsalicylic acid (ASA) treatment. However, long term treatment (started after 3-6 months after stroke/TIA) with Aggrenox was safe and superior to ASA treatment in preventing recurrent strokes. There is no evidence for ASA to prevent from neurological progression after stroke during the first 3 months. Results from a cohort study suggest that starting Aggrenox within 72 hours after stroke predicts clinical improvement in the NIHSS at discharge from the hospital. Dipyridamole suppresses acute inflammatory responses to stroke.

This study is designed to investigate the tolerability and efficacy of a secondary stroke prevention treatment with Aggrenox when initiated within 24 hours of stroke onset on a stroke unit compared to later initiation after a 7 day ASA treatment and outside off a stroke unit setting.

Vascular Access Clinical Trials Data Coordinating Center [Completed]
Fistula Study: The objective of the study is to determine whether clopidogrel reduces the early failure rate of native AV fistulae.

Graft Study: The objective of the study is to determine whether Aggrenox (Boehringer-Ingelheim) prolongs primary unassisted patency in newly created arteriovenous grafts.

Treatment of Supine Hypertension in Autonomic Failure [Recruiting]
Supine hypertension is a common problem that affects at least 50% of patients with primary autonomic failure. Supine hypertension can be severe, and complicates the treatment of orthostatic hypotension. Drugs used for the treatment of orthostatic hypotension (eg, fludrocortisone and pressor agents), worsen supine hypertension. High blood pressure may also cause target organ damage in this group of patients. The pathophysiologic mechanisms causing supine hypertension in patients with autonomic failure have not been defined.

In a study, we, the investigators at Vanderbilt University, examined 64 patients with AF, 29 with pure autonomic failure (PAF) and 35 with multiple system atrophy (MSA). 66% of patients had supine systolic (systolic blood pressure [SBP] > 150 mmHg) or diastolic (diastolic blood pressure [DBP] > 90 mmHg) hypertension (average blood pressure [BP]: 179 ┬▒ 5/89 ┬▒ 3 mmHg in 21 PAF and 175 ┬▒ 5/92 ┬▒ 3 mmHg in 21 MSA patients). Plasma norepinephrine (92 ┬▒ 15 pg/mL) and plasma renin activity (0. 3 ┬▒ 0. 05 ng/mL per hour) were very low in a subset of patients with AF and supine hypertension. (Shannon et al., 1997).

Our group has showed that a residual sympathetic function contributes to supine hypertension in patients with severe autonomic failure and that this effect is more prominent in patients with MSA than in those with PAF (Shannon et al., 2000). MSA patients had a marked depressor response to low infusion rates of trimethaphan, a ganglionic blocker; the response in PAF patients was more variable. At 1 mg/min, trimethaphan decreased supine SBP by 67 +/- 8 and 12 +/- 6 mmHg in MSA and PAF patients, respectively (P < 0. 0001). MSA patients with supine hypertension also had greater SBP response to oral yohimbine, a central alpha2 receptor blocker, than PAF patients. Plasma norepinephrine decreased in both groups, but heart rate did not change in either group. This result suggests that residual sympathetic activity drives supine hypertension in MSA; in contrast, supine hypertension in PAF.

It is hoped that from this study will emerge a complete picture of the supine hypertension of autonomic failure. Understanding the mechanism of this paradoxical hypertension in the setting of profound loss of sympathetic function will improve our approach to the treatment of hypertension in autonomic failure, and it could also contribute to our understanding of hypertension in general.

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Reports of Suspected Aggrenox (Aspirin / Dipyridamole) Side Effects

Headache (25)Hypotension (16)Nausea (14)Cerebral Haemorrhage (11)Loss of Consciousness (11)Decreased Appetite (11)Convulsion (11)Gastrooesophageal Reflux Disease (9)Asthenia (9)Dementia (8)more >>


Page last updated: 2014-04-10

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