Description
Curantil Pharmacodynamics
Dipyridamole inhibits platelet aggregation and adhesion, improves microcirculation, and has a mild vasodilator effect. The mechanism by which dipyridamole has an inhibitory effect on platelet aggregation is associated with the inhibition of adenosine reuptake (platelet reactivity inhibitor) by endothelial cells, red blood cells and platelets; activation of adenylate cyclase and inhibition of platelet phosphodiesterase. Thus, dipyridamole prevents the release of aggregation activators from platelets – thromboxane (TxA2), ADP, serotonin, etc. Dipyridamole increases synthesis of prostacyclin PgI2 by vascular endothelium, normalizes the ratio of PgI2 to TxA2, preventing platelet aggregation, and increases synthesis of endothelial nitric oxide (NO). Dipyridamole reduces platelet adhesiveness, prevents the formation of blood clots in vessels and stabilizes blood flow in the ischemic focus.
Dipyridamole dose-dependently prolongs pathologically shortened life time of platelets.
Dipyridamole, due to its vasodilatory properties, helps to reduce total peripheral vascular resistance, improves microcirculation, has angioprotective effect. These effects are due to increased activity of endogenous adenosine (adenosine affects vascular smooth muscle and prevents release of norepinephrine). Dipyridamole has both angiogenic and arteriogenic activity, stimulating the formation of new capillaries and collateral arteries.
Dipyridamole normalizes venous outflow, reduces the incidence of deep vein thrombosis in the postoperative period. It improves microcirculation in the retina and renal tubules.
In neurological practice such pharmacodynamic effects of dipyridamole as reduction of cerebral vascular tone and improvement of cerebral circulation are used. According to angiographic studies, the use of dipyridamole in combination with acetylsalicylic acid (ASA) can slow the progression of atherosclerosis.
In obstetric practice dipyridamole is used to improve placental blood flow and prevent dystrophic changes in the placenta, eliminate hypoxia of fetal tissues and the accumulation of glycogen in them. Thus, it is reasonable to use dipyridamole in early manifestations of placental insufficiency, in pregnant women with high risk of placental insufficiency: intrauterine infection, gestosis (threatened preeclampsia and eclampsia), autoimmune pathology, extragenital diseases (diabetes, metabolic syndrome), and diseases prone to thrombosis.
As pyrimidine derivative, dipyridamole is an interferon inducer and has a modulatory effect on functional activity of interferon system, in vitro increases reduced production of interferon alpha (α) and gamma (γ) by blood leukocytes. Increases nonspecific antiviral resistance to viral infections.
Indications
– Treatment and prevention of cerebral circulation disorders of the ischemic type;
– discirculatory encephalopathy;
– Prevention of arterial and venous thrombosis and its complications;
– Prevention of thromboembolism after heart valve replacement surgery;
– Prevention of placental insufficiency in complicated pregnancy;
– as a part of complex therapy for microcirculatory disorders of any genesis;
– As an interferon inducer and immunomodulator for the prevention and treatment of influenza, SARS.
Contraindications .
– Hypersensitivity to the components of the drug;
– Sucrose/isomaltase deficiency, galactose intolerance, lactase deficiency, glucose-galactose malabsorption;
– acute myocardial infarction;
– unstable angina pectoris;
– widespread stenotic atherosclerosis of coronary arteries;
– subaortic stenosis;
– decompensated heart failure;
– severe arterial hypotension; collapse;
– severe arterial hypertension;
– severe cardiac rhythm disturbances;
– chronic obstructive pulmonary disease (COPD);
– decompensated renal failure;
– hepatic insufficiency;
– hemorrhagic diathesis;
– Diseases prone to bleeding (gastric ulcer and duodenal ulcer, etc.);
– Children under 12 years of age (efficacy and safety have not been studied).
Pregnancy and lactation:
The use of the drug Curantil® N 25 during pregnancy and during breastfeeding is possible only if the anticipated benefit to the mother exceeds the possible risk to the fetus and child. The duration of the treatment course is determined by the physician.
Dosage and administration
- Tablets are taken orally, on an empty stomach, with a little water, without breaking and biting. Dose of the drug is adjusted according to the indications, the severity of the disease and the patient’s reaction to treatment. The duration of the course of treatment is determined by the doctor.
- For reduction of platelet aggregation, it is recommended to take Curantil® N 25 in daily dose of 75-225 mg.
- In severe cases, the daily dose can be increased up to 600 mg.
- For prophylaxis of placental insufficiency, it is recommended to take Curantil® N 25 in dose of 25 mg (1 tablet 3 times per day). The maximum recommended daily dose is 225 mg.
- For prophylaxis and treatment of cerebrovascular disease, the daily dose of dipyridamole is 225-450 mg (3 tablets of the preparation Courantil® N 25 3-6 times daily).
- For prevention of influenza and other acute respiratory infections, especially during epidemics, it is recommended to take the drug Curantil® N 25 according to the following scheme: 50 mg (2 tablets) once every 7 days for 4-5 weeks.
- For prevention of relapses in patients with frequent respiratory viral infections, it is recommended to take the drug Curantil® N 25 according to the following regimen: 100 mg (2 tablets 2 times a day with an interval of 2 hours) once a week during 8-10 weeks.
- Curantil® N 25 is suitable for long-term treatment.
