Aspirin + Dipyridamole interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

  What to do: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

  1 source

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):

• coffee

  Moderate

  Antagonism

  Caffeine and other xanthine derivatives (e.g., theophylline) are nonspecific, competitive antagonists of adenosine receptors. As such, they may interfere with the vasodilating effect of dipyridamole, an adenosine receptor agonist.

  What to do: Patients should avoid consumption of caffeine-containing products for at least 24 hours prior to administration of dipyridamole for myocardial perfusion imaging.

  3 sources

  1. Smits P, Aengevaeren WR, Corstens FH, Thien T "Caffeine reduces dipyridamole-induced myocardial ischemia." J Nucl Med 30 (1989): 1723-6
  2. "Product Information. Persantine (dipyridamole)." Boehringer-Ingelheim (2002):
  3. Ranhosky A, Kempthorne-Rawson J, the Intravenous Dipyridamole Thallium Imaging Study Group "The safety of intravenous dipyridamole thallium myocardial perfusion imaging." Circulation 81 (1990): 1205-9

Conditions

Conditions in which Aspirin + Dipyridamole needs care, as documented in this source.

• Asthma

  Major

  Nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in patients with history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs; severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients. A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polyps, severe potentially fatal bronchospasm, and/or intolerance to aspirin and other NSAIDs. Since cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients, therapy with any NSAID should be avoided in patients with this form of aspirin sensitivity. NSAIDs should be used with caution in patients with preexisting asthma (without known aspirin sensitivity), and these patients should be monitored for changes in the signs and symptoms of asthma.

  15 sources

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
  2. "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
  3. "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
  4. "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
  5. "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
  6. "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
  7. "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
  8. "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):

  Show all 15 sourcesShow fewer sources

  9. "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
  10. "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
  11. "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
  12. "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
  13. "Product Information. Daypro (oxaprozin)." Searle (2001):
  14. "Product Information. Celebrex (celecoxib)." Searle (2001):
  15. "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):

• Blood Coagulation Disorders

  Major

  The use of aspirin is contraindicated in patients with significant active bleeding or hemorrhagic disorders such as hemophilia, von Willebrand's disease, or telangiectasia. Aspirin interferes with coagulation by irreversibly inhibiting platelet aggregation and prolonging bleeding time. The non-aceylated salicylates (i.e. salicylate salts such as sodium or magnesium salicylate) do not demonstrate these effects and may be appropriate substitutions in these patients. However, all salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially aspirin, should be administered with extreme caution in patients with hypoprothrombinemia, vitamin K deficiency, thrombocytopenia, thrombotic thrombocytopenic purpura, severe hepatic impairment, or anticoagulant use.

  14 sources

  1. Moroz LA "Increased blood fibrinolytic activity after aspirin ingestion." N Engl J Med 296 (1977): 525-9
  2. Garg SK, Sarker CR "Aspirin-induced thrombocytopenia on an immune basis." Am J Med Sci 267 (1974): 129-32
  3. Sbarbaro JA, Bennett RM "Aspirin hepatotoxicity and disseminated intravascular coagulation." Ann Intern Med 86 (1977): 183-5
  4. Bochner F, Williams DB, Morris PM, Siebert DM, Lloyd JV "Pharmacokinetics of low-dose oral modified release, soluble and intravenous aspirin in man, and effects on platelet function." Eur J Clin Pharmacol 35 (1988): 287-94
  5. Patrono C "Aspirin as an antiplatelet drug." N Engl J Med 330 (1994): 1287-94
  6. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  7. Ferraris VA, Ferraris SP "Preoperative aspirin ingestion increases operative blood loss after coronary artery bypass grafting - update." Ann Thorac Surg 59 (1995): 1036-7
  8. Buerke M, Pittroff W, Meyer J, Darius H "Aspirin therapy: optimized platelet inhibition with different loading and maintenance doses." Am Heart J 130 (1995): 465-72

  Show all 14 sourcesShow fewer sources

  9. Hirsh J, Dalen JE, Fuster V, Harker LB, Patrono C, Roth G "Aspirin and other platelet-active drugs: the relationship among dose, effectiveness, and side effects." Chest 108 Suppl (1995): s247-57
  10. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  11. He J, Whelton PK, Vu B, Klag MJ "Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials." JAMA 280 (1998): 1930-35
  12. Petty GW, Brown RD, Whisnant JP, Sicks JD, O'Fallon WM, Wiebers DO "Frequency of major complications of aspirin, warfarin, and intravenous heparin for secondary stroke prevention: a population study." Ann Intern Med 130 (1999): 14-22
  13. "Product Information. Bayer Aspirin (acetylsalicylsyra)." Bayer
  14. Colwell JA "Aspirin and risk of hemorrhagic stroke." JAMA 282 (1999): 731-2

• Bronchial Spasm

  Major

  Dipyridamole is a phosphodiesterase inhibitor and can exacerbate bronchospasm, particularly in patients with reactive airway disease and/or chronic obstructive pulmonary disease (COPD). Therapy with dipyridamole is contraindicated in patients with active wheezing and should be administered cautiously in patients with asthma or COPD.

  3 sources

  1. Lette J, Cerino M, Laverdiere M, Tremblay J, Prenovault J "Severe bronchospasm followed by respiratory arrest during thallium- dipyridamole imaging." Chest 95 (1989): 1345-7
  2. Eagle KA, Boucher CA "Intravenous dipyridamole infusion causes severe bronchospasm in asthmatic patients." Chest 95 (1989): 258-9
  3. "Product Information. Persantine (dipyridamole)." Boehringer-Ingelheim (2002):

• Kidney Diseases

  Major

  Salicylate and its metabolites are eliminated almost entirely by the kidney. Therapy with salicylate drugs should be administered cautiously in patients with renal impairment, especially if it is severe. Reduced dosages may be necessary to avoid drug accumulation. Clinical monitoring of renal function is recommended during prolonged therapy, since the use of salicylate drugs has rarely been associated with renal toxicities, including elevations in serum creatinine, renal papillary necrosis, and acute tubular necrosis with renal failure. Most of the data have been derived from experience with aspirin but may apply to other salicylates as well. In patients with impaired renal function, aspirin has caused reversible and sometimes marked decreases in renal blood flow and glomerular filtration rate. Adverse renal effects have usually reversed rapidly following withdrawal of aspirin therapy.

  11 sources

  1. Kimberly RP, Plotz PH "Aspirin-induced depression of renal function." N Engl J Med 296 (1977): 418-24
  2. Riegger GA, Kahles HW, Elsner D, Kromer EP, Kochsiek K "Effects of acetylsalicylic acid on renal function in patients with chronic heart failure." Am J Med 90 (1991): 571-5
  3. Carmichael J, Shankel SW "Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function." Am J Med 78 (1985): 992-1000
  4. Wen SF, Parthasarathy R, Iliopoulos O, Oberley TD "Acute renal failure following binge drinking and nonsteroidal antiinflammatory drugs." Am J Kidney Dis 20 (1992): 281-5
  5. Maher JF "Analgesic nephropathy. Observations, interpretations, and perspective on the low incidence in America." Am J Med 76 (1984): 345-8
  6. Muther RS, Potter DM, Bennett WM "Aspirin-induced depression of glomerular filtration rate in normal humans: role of sodium balance." Ann Intern Med 94 (1981): 317-21
  7. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  8. Whelton A "Renal effects of over-the-counter analgesics." J Clin Pharmacol 35 (1995): 454-63

  Show all 11 sourcesShow fewer sources

  9. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  10. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  11. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):

• Peptic Ulcer

  Major

  Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.

  19 sources

  1. Bergmann JF, Chassany O, Geneve J, Abiteboul M, Caulin C, Segrestaa JM "Endoscopic evaluation of the effect of ketoprofen, ibuprofen and aspirin on the gastroduodenal mucosa." Eur J Clin Pharmacol 42 (1992): 685-8
  2. Mehta S, Dasarathy S, Tandon RK, Mathur M, Malaviya AN "A prospective randomized study of the injurious effects of aspirin and naproxen on the gastroduodenal mucosa in patients with rheumatoid arthritis." Am J Gastroenterol 87 (1992): 996-1000
  3. Naschitz JE, Yeshurun D, Odeh M, Bassan H, Rosner I, Stermer E, Levy N "Overt gastrointestinal bleeding in the course of chronic low-dose aspirin administration for secondary prevention of arterial occlusive disease." Am J Gastroenterol 85 (1990): 408-11
  4. Sabesin SM, Boyce HW Jr, King CE, Mann JA, Ruoff G, Wall E "Comparative evaluation of gastrointestinal intolerance produced by plain and tri-buffered aspirin tablets." Am J Gastroenterol 83 (1988): 1220-5
  5. Graham DY, Smith JL "Aspirin and the stomach." Ann Intern Med 104 (1986): 390-8
  6. Levy M, Miller DR, Kaufman DW, Siskind V, Schwingl P, Rosenberg L, Strom B, Shapiro S "Major upper gastrointestinal tract bleeding. Relation to the use of aspirin and other nonnarcotic analgesics." Arch Intern Med 148 (1988): 281-5
  7. Prichard PJ, Kitchingman GK, Walt RP, Daneshmend TK, Hawkey CJ "Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin." BMJ 298 (1989): 493-6
  8. Roderick PJ, Wilkes HC, Meade TW "The gastrointestinal toxicity of aspirin: an overview of randomised controlled trials." Br J Clin Pharmacol 35 (1993): 219-26

  Show all 19 sourcesShow fewer sources

  9. Wilcox CM, Shalek KA, Cotsonis G "Striking prevalence of over-the-counter nonsteroidal anti- inflammatory drug use in patients with upper gastrointestinal hemorrhage." Arch Intern Med 154 (1994): 42-6
  10. Silagy CA, McNeil JJ, Donnan GA, Tonkin AM, Worsam B, Campion K "Adverse effects of low-dose aspirin in a healthy elderly population." Clin Pharmacol Ther 54 (1993): 84-9
  11. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  12. Weil J, Colinjones D, Langman M, Lawson D, Logan R, Murphy M, Rawlins M, Vessey M, Wainwright P "Prophylactic aspirin and risk of peptic ulcer bleeding." BMJ 310 (1995): 827-30
  13. Savon JJ, Allen ML, Dimarino AJ, Hermann GA, Krum RP "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  14. Stalnikowiczdarvasi R "Gastrointestinal bleeding during low-dose aspirin administration for prevention of arterial occlusive events: a critical analysis." J Clin Gastroenterol 21 (1995): 13-6
  15. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  16. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  17. Marks RD "Aspirin use and fecal occult blood testing." Am J Med 100 (1996): 596-7
  18. Greenberg PD, Cello JP, Rockey DC "Asymptomatic chronic gastrointestinal blood loss in patients taking aspirin or warfarin for cardiovascular disease." Am J Med 100 (1996): 598-604
  19. Lanas A, Serrano P, Bajador E, Esteva F, Benito R, Sainz R "Evidence of aspirin use in both upper and lower gastrointestinal perforation." Gastroenterology 112 (1997): 683-9

• Reye Syndrome

  Major

  The use of salicylates, primarily aspirin, in children with varicella infections or influenza-like illnesses has been associated with an increased risk of Reye's syndrome. Although a causal relationship has not been established, the majority of evidence to date seems to support the association. Most authorities, including the American Academy of Pediatrics Committee on Infectious Diseases, recommend avoiding the use of salicylates in children and teenagers with known or suspected varicella or influenza and during presumed outbreaks of influenza. If antipyretic or analgesic therapy is indicated under these circumstances, acetaminophen may be an appropriate alternative. The same precautions should also be observed with related agents such as salicylamide or diflunisal because of their structural and pharmacological similarities to salicylate.

  9 sources

  1. Epidemiology Office, Divisiion of Viral and Rickettsial Diseasses, Center for Infectious Diseases, Centers for Disease Control. "Leads from the MMWR. Reye syndrome surveillance--United States, 1987 and 1988." JAMA 261 (1989): 3520,
  2. Hasking GJ, Duggan JM "Encephalopathy from bismuth subsalicylate." Med J Aust 2 (1982): 167
  3. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals (2001):
  4. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  5. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  6. Arvin A, Kliegman R, Nelson W, Behrman R, eds. "Nelson Textbook of Pediatrics." Philadelphia, PA: W.B. Saunders Company (1996):
  7. American Academy of Pediatrics. Committee on Infectious Diseases; Peter G, ed. "Red BooK: Report of the Committee on Infectious Diseases." Grove Village, IL: American Academy of Pediatrics (1997):
  8. Belay ED, Bresee JS, Holman RC, Khan AS, Shahriari A, Schonberger LB "Reye's syndrome in the United States from 1981 through 1997." N Engl J Med 340 (1999): 1377-82

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):

• Anemia

  Moderate

  Occult, often asymptomatic GI blood loss occurs quite frequently with the use of normal dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. Other salicylates reportedly cause little or no GI blood loss at usual dosages, but may do so at high dosages. Prolonged therapy with salicylates, particularly aspirin, should be administered cautiously in patients with or predisposed to anemia. Periodic monitoring of hematocrit is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.

  8 sources

  1. Naschitz JE, Yeshurun D, Odeh M, Bassan H, Rosner I, Stermer E, Levy N "Overt gastrointestinal bleeding in the course of chronic low-dose aspirin administration for secondary prevention of arterial occlusive disease." Am J Gastroenterol 85 (1990): 408-11
  2. Prichard PJ, Kitchingman GK, Walt RP, Daneshmend TK, Hawkey CJ "Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin." BMJ 298 (1989): 493-6
  3. Savon JJ, Allen ML, Dimarino AJ, Hermann GA, Krum RP "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  4. Stalnikowiczdarvasi R "Gastrointestinal bleeding during low-dose aspirin administration for prevention of arterial occlusive events: a critical analysis." J Clin Gastroenterol 21 (1995): 13-6
  5. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  6. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  7. Marks RD "Aspirin use and fecal occult blood testing." Am J Med 100 (1996): 596-7
  8. Greenberg PD, Cello JP, Rockey DC "Asymptomatic chronic gastrointestinal blood loss in patients taking aspirin or warfarin for cardiovascular disease." Am J Med 100 (1996): 598-604

• Diseases requiring dialysis

  Moderate

  Salicylate and its metabolites are readily removed by hemodialysis and, to a lesser extent, by peritoneal dialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

  3 sources

  1. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  2. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  3. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):

• Glucosephosphate Dehydrogenase Deficiency

  Moderate

  Salicylates, particularly aspirin, may cause or aggravate hemolysis in patients with pyruvate kinase or glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. However, this effect has not been clearly established. Until more data are available, therapy with salicylates should be administered cautiously in patients with G-6-PD deficiency. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.

  3 sources

  1. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  2. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  3. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):

• Hypotension

  Moderate

  Dipyridamole can cause peripheral vasodilation. Therapy with dipyridamole should be administered cautiously in patients with hypotension.

  5 sources

  1. Castello R, Hidalgo R "Dipyridamole-induced myocardial ischemia ." JAMA 259 (1988): 1179
  2. "Product Information. Persantine (dipyridamole)." Boehringer-Ingelheim (2002):
  3. Roach PJ, Magee MA, Freedman SB "Asystole and bradycardia during dipyridamole stress testing in patients receiving beta blockers." Int J Cardiol 42 (1993): 92-4
  4. Mauro RL, Sabella FP, Enia F "Sinus arrest associated with dipyridamole infusion." Chest 105 (1994): 604-5
  5. Lo Mauro R, Sabella FP, Enia F "Sinus arrest associated with dipyridamole infusion." Chest 106 (1994): 984

• Liver Diseases

  Moderate

  The use of salicylates has occasionally been associated with acute, reversible hepatotoxicity, primarily manifested as elevations of serum transaminases, alkaline phosphatase and/or, rarely, bilirubin. Hepatic injury consistent with chronic active hepatitis has also been reported in a few patients, which resulted rarely in encephalopathy or death. Salicylate-induced hepatotoxicity appears to be dependent on serum salicylate concentration (> 25 mg/dL) and has occurred most frequently in patients with juvenile arthritis, active systemic lupus erythematosus, rheumatic fever, or preexisting hepatic impairment. Therapy with salicylates, particularly when given in high dosages, should be administered cautiously in these patients, and periodic monitoring of liver function is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate. A dosage reduction may be necessary if liver function abnormalities develop and serum salicylate concentration exceeds 25 mg/dL, although serum transaminase elevations may sometimes be transient and return to pretreatment values despite continued therapy without dosage adjustment.

  8 sources

  1. Seaman WE, Ishak KG, Plotz PH "Aspirin-induced hepatotoxicity in patients with systemic lupus erythematosus." Ann Intern Med 80 (1974): 1-8
  2. Wolfe JD, Metzger AL, Goldstein RC "Aspirin hepatitis." Ann Intern Med 80 (1974): 74-6
  3. Sbarbaro JA, Bennett RM "Aspirin hepatotoxicity and disseminated intravascular coagulation." Ann Intern Med 86 (1977): 183-5
  4. Jorup-Ronstrom C, Beermann B, Wahlin-Boll E, Melander A, Britton S "Reduction of paracetamol and aspirin metabolism during viral hepatitis." Clin Pharmacokinet 11 (1986): 250-6
  5. Patel DK, Hesse A, Ogunbona A, Notarianni LJ, Bennett PN "Metabolism of aspirin after therapeutic and toxic doses." Hum Exp Toxicol 9 (1990): 131-6
  6. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  7. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  8. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):

• Long QT Syndrome

  Moderate

  Serious adverse reactions associated with the administration of intravenous dipyridamole have included cardiac death, fatal and non- fatal myocardial infarction, ventricular fibrillation, symptomatic ventricular tachycardia, stroke, transient cerebral ischemia, seizures, anaphylactoid reaction and bronchospasm. There have been reported cases of asystole, sinus node arrest, sinus node depression and conduction block. Patients with abnormalities of cardiac impulse formation/conduction or severe coronary artery disease may be at increased risk for these events. Caution is recommended.

  1 source

  1. "Product Information. Persantine (dipyridamole)." Boehringer-Ingelheim (2002):

• Myasthenia Gravis

  Moderate

  Myasthenia gravis patients receiving therapy with cholinesterase inhibitors may experience worsening of their disease in the presence of dipyridamole. Caution should be exercised with these patients.

  1 source

  1. "Product Information. Persantine (dipyridamole)." Boehringer-Ingelheim (2002):

Therapeutic duplication

Drug classes that overlap with Aspirin + Dipyridamole, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Consensi

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Famotidine/ibuprofen

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Esomeprazole/naproxen

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Phosphasal

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Treximet

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Chlorpheniramine/ibuprofen/pseudoephedrine

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Acetaminophen/caffeine/magnesium salicylate

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Trilisate

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Combunox

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Diclofenac/misoprostol

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Acetaminophen/magnesium salicylate/pamabrom

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Ibuprofen/pseudoephedrine

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Diphenhydramine/ibuprofen

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Methenamine/sodium salicylate

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Acetaminophen/ibuprofen

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Ibuprofen/phenylephrine

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Zynrelef

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Seglentis

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Doans pm

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Prosed ds

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Chlorpheniramine/ibuprofen/phenylephrine

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Naproxen/pseudoephedrine

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Reprexain

• nonsteroidal anti-inflammatories

  The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category.

  Example product in the source data (US market): Diphenhydramine/naproxen