Section 13 · Monograph
Aspirin-dipyridamole
Reviewed Nov 2026FDA label
AggrenoxAntiplatelet combination
- Forms
- ER cap: 25/200mg
- Dose
- 1 cap BID (secondary stroke prevention)
- MOA
- COX-1 inhibition + phosphodiesterase/adenosine reuptake inhibition
Indications
- Reduce risk of stroke in patients who have had a TIA or ischemic strokeFDA-labeled
Mechanism of Action
- Aspirin irreversibly inhibits COX-1
- Dipyridamole inhibits adenosine reuptake and phosphodiesterase, raising cAMP/cGMP in platelets
Full Dosing
Adult / usual
- One capsule (aspirin 25mg / extended-release dipyridamole 200mg) twice daily with food
- Swallow whole; do not crush or chew
- If intolerable headache at initiation, may temporarily use one capsule at bedtime plus low-dose aspirin in the morning for about a week
Contraindications
- Hypersensitivity to dipyridamole, aspirin or NSAIDs
- Children and teens with viral illness (Reye syndrome)
- Active bleeding
Drug Interactions
- Anticoagulants and NSAIDs increase bleeding risk
- Potentiates adenosine effects
- Dipyridamole may counteract cholinesterase inhibitors (relevant in myasthenia gravis)
Adverse Effects
- Headache (common, often early)
- GI upset, dizziness
- Bleeding
- Dipyridamole may provoke angina in significant coronary disease
Monitoring Parameters
- Headache tolerance
- Bleeding signs and CBC
- Renal and hepatic function
Pregnancy & Lactation
- Avoid in the third trimester because of aspirin; weigh benefit and risk