Dipyridamole/Aspirin, Oral

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KEY POINTS

• This medicine is taken by mouth to help prevent blood clots and reduce the risk of future strokes. Take it exactly as directed.
• If you have a bleeding disorder, liver disease, or a vitamin K deficiency, the aspirin in this medicine may cause you to bleed more.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: platelet aggregation inhibitor (medicine that reduces the chance of blood clots forming)

Generic and brand names: dipyridamole/aspirin, oral; Aggrenox

What is this medicine used for?

This medicine is taken by mouth to reduce the risk of future strokes in people who have had a mini-stroke (transient ischemic attack or TIA) or stroke due to blood clots. It contains 2 medicines to help prevent blood clots.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stomach ulcer
• A bleeding disorder or blood clotting problem
• Angina (chest pain) or coronary artery disease
• Asthma
• Liver or kidney disease
• Low blood pressure
• Myasthenia gravis
• Nasal polyps

Tell your healthcare provider if you drink alcohol.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. This medicine may cause harm to an unborn baby and should not be taken during the 4th through 9th months of pregnancy. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. You need to take this medicine regularly every day to reduce the risk of future strokes. Do not stop taking this medicine without your healthcare provider's approval.

Do not use this medicine in children under age 18.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach. Swallow the capsules whole. Do not break, crush, or chew them.

What if I miss a dose?

If you miss a dose, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: flushing; sweating; seizures; dizziness; weakness; restlessness; fast heartbeat; lightheadedness; fainting; vomiting up blood, headache; ringing in the ears.

What should I watch out for?

This medicine contains aspirin. Do not give this medicine to children or teenagers who have a viral infection with or without a fever. There is a risk of a reaction called Reye's syndrome.

You may get a headache when you first start taking this medicine. This is a sign that the medicine is starting to work. If the headache is severe, contact your healthcare provider. Headaches should go away as your body adjusts to the medicine. Ask your healthcare provider if you should take acetaminophen (Tylenol) to relieve these headaches. Do not take additional aspirin or products that contain aspirin unless directed to do so by your healthcare provider. If you are not sure about which products contain aspirin, ask your pharmacist.

If you have a bleeding disorder, liver disease, or a vitamin K deficiency, the aspirin in this medicine may cause you to bleed more. Talk with your healthcare provider about this.

Do not drink alcohol without your provider’s approval. People who have 3 or more alcoholic drinks every day when taking this medicine have a higher risk of bleeding.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

Your healthcare provider may want to check you regularly or do blood tests while you are taking this medicine. Keep all appointments.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Bloody or black tarry bowel movements, vomiting material that looks like coffee grounds, severe stomach pain or diarrhea, severe nausea or vomiting, unusual bruising or bleeding, new or worsening chest pain, shortness of breath, irregular or slow heartbeat, severe dizziness or lightheadedness, fainting, flushing of the face, stomach cramps, severe rash or itching, blistering or peeling skin, unusual tiredness or weakness, severe drowsiness, confusion or memory problems, ringing in your ears, hearing loss, dark urine, yellowing of eyes or skin, light-colored bowel movements, loss of appetite, trouble urinating, seizures.

Other: Mild headache, mild stomach pain, heartburn, diarrhea, mild nausea, tiredness, back pain, muscle or joint pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
• Adenosine (Adenocard)
• Alzheimer’s disease medicines such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)
• Anagrelide (Agrylin)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antacids
• Antibiotics such as ciprofloxacin (Cipro), erythromycin (E.E.S., Ery-Tab, Erythrocin), and rifampin (Rifadin)
• Antidepressants such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline (Zoloft)
• Antipsychotic medicines such as paliperidone (Invega) and risperidone (Risperdal)
• Antiseizure medicines such as phenytoin (Dilantin, Phenytek), topiramate (Qudexy, Topamax, Trokendi), valproic acid (Depacon, Depakene, Depakote), and zonisamide (Zonegran)
• Aspirin and other salicylates
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as bosutinib (Bosulif), ceritinib (Zykadia), crizotinib (Xalkori), doxorubicin (Doxil), imatinib (Gleevec), omacetaxine (Synribo), pazopanib (Votrient), pralatrexate (Folotyn), topotecan (Hycamtin), vemurafenib (Zelboraf), and vincristine (Marqibo)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor) and lovastatin (Altoprev)
• Colchicine (Colcrys)
• Corticosteroids such as betamethasone, cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Diabetes medicines such as chlorpropamide, glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), and tolbutamide
• Diuretics (water pills) such as acetazolamide (Diamox), amiloride, bumetanide, chlorothiazide (Diuril), chlorthalidone, furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), diltiazem (Cardizem, Cartia, Tiazac), nicardipine (Cardene), quinidine, and verapamil (Calan, Covera, Verelan)
• HIV medicines such as fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase), and tipranavir (Aptivus)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Live vaccines
• Medicines to block or prevent stomach acid such as cimetidine (Tagamet) and ranitidine (Zantac)
• Medicines to treat or prevent blood clots such as clopidogrel (Plavix), dabigatran (Pradaxa), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, prasugrel (Effient), rivaroxaban (Xarelto), and warfarin (Coumadin)
• Medicines to treat pulmonary hypertension such as epoprostenol (Flolan, Veletri), iloprost (Ventavis), and treprostinil (Remodulin, Tyvaso)
• Methazolamide (Neptazane)
• Methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall)
• Morphine (Kadian, MS Contin)
• Myasthenia gravis medicines such as neostigmine (Prostigmin) and pyridostigmine (Mestinon, Regonol)
• Natural remedies such as alfalfa, anise, bilberry, black cohosh, cat's claw, dong quai, evening primrose oil, feverfew, garlic, ginger, ginkgo biloba, ginseng, glucosamine, green tea, horse chestnut, red clover, and SAMe
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), diflunisal, etodolac, ibuprofen (Advil, Motrin), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Probenecid
• Propranolol (Hemangeol, Inderal, InnoPran)
• Riociguat (Adempas)
• Silodosin (Rapaflo)
• Tolvaptan (Samsca)
• Vitamin E or multivitamins that contain vitamin E

Do not drink alcohol while you are taking this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.