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Dipyridamole

Also indexed as: Permole®, Persantine®

Dipyridamole prevents platelet clumping and is used with warfarin (Coumadin®) to prevent blood clots from forming after heart valve replacement. It may be used alone or combined with aspirin to prevent strokes.

Interactions with Dietary Supplements

Iron
Some studies suggest the taking of too much iron by individuals who are not iron deficient can result in tissue damage that may contribute to heart disease.1 Test tube studies have shown dipyridamole blocks platelet clumping caused by iron,2 which might reduce the damage caused by this mineral. Controlled human studies are needed to test this possibility.

Interactions with Herbs

Garlic (Allium sativa)
A test tube study has shown ajoene, a compound found in garlic that prevents platelet clumping, enhances the beneficial action of dipyridamole on human platelets.3 Controlled research is needed to determine whether taking garlic supplements together with dipyridamole might enhance the effectiveness of either compound taken alone.

Interactions with Foods and Other Compounds

Coffee and Caffeine
Taking dipyridamole can cause a reduction in the amount of oxygen delivered to the heart, resulting in a rare side effect known as angina pectoris. Because dipyridamole has this effect, it has sometimes been used in heart stress tests. One person who consumed coffee prior to the test failed to experience the expected reduction in blood flow caused by dipyridamole.4 Controlled studies are needed to determine whether consumption of beverages containing caffeine might reduce the likelihood of developing angina from the drug.

Summary of Interactions for Dipyridamole

Depletion or interference Iron*
Adverse interaction None known
Side effect reduction/prevention None known
Supportive interaction Garlic*
Reduced drug absorption/bioavailability None known
Other (see text) Caffeine

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Tzonou A, Lagiou P, Trichopoulou A, et al. Dietary iron and coronary heart disease risk: a study from Greece. Am J Epidemiol 1998;147:161–6.

2. De la Cruz JP, Garcia PJ, Sanchez de la Cuesta F. Dipyridamole inhibits platelet aggregation induced by oxygen-derived free radicals. Thromb Res 1992;66:277–85.

3. Apitz-Castro R, Escalante J, Vargas R, Jain MK. Ajoene, the antiplatelet principle of garlic, synergistically potentiates the antiaggregatory action of prostacyclin, forskolin, indomethacin and dipyridamole on human platelets. Thromb Res 1986;42:303–11.

4. Smits P, Aengevaeren WR, Corstens FH, Thien T. Caffeine reduces dipyridamole-induced myocardial ischemia. J Nucl Med 1989;30:1723–6.