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Aggrenox (dipyridamole, aspirin) is a blood thinner and vasodilator, most commonly prescribed to prevent stroke in patients who have a history of stroke or who are at high risk of having a stroke due to blood clots.

Aggrenox contains two active ingredients:

• Aspirin is a widely known NSAID (nonsteroidal anti-inflammatory drug) that, in addition to reducing inflammation, pain, and fever, inhibits the formation of blood clots.
• Dipyridamole also inhibits the formation of blood clots and has additional vasodilation properties, which improves blood flow.

Both aspirin and dipyridamole are antiplatlet drugs, meaning they prevent blood clots from forming. Antiplatet medications are distinct from anticoagulant medications, such as the widely-recognized warfarin, which simply slow the formation of blood clots.

Aggrenox is a potent, potentially life-saving treatment, but as with any powerful medication it carries risk of serious complications if misused. Patients are strongly encouraged to follow doctor instructions carefully for the duration of treatment.

Stroke Prevention with Aggrenox

Aggrenox is administered via capsules, which only come in one strength; each capsule contains 25 mg aspirin and 200 mg dipyridamole. The dipyridamole is slowly released over the course of the day, so it's important to swallow the capsule whole. Crushing, dissolving, or otherwise damaging the capsule may cause the medication to release too quickly, which increases risk of side effects.

Treatment is usually similar for all patients:

• Treatment typically consists of taking two tablets per day, one in morning and one in the evening.
• Some patients experience severe headaches upon starting treatment. If this occurs, one tablet should be taken in the evening and an aspirin-only dose taken in the morning.
• The regular, two-tablets-per-day regimen should be resumed after one week of the modified treatment; most patients stop experiencing headaches after the body has had a week to adjust to treatment with lower doses.

Duration of treatment will vary according to individual circumstances. It is usually long-term, spanning years. Some patients will remain on Aggrenox or a similar medication for the remainder of life.

Important Considerations

This medication can cause very serious complications in some medical conditions, and it can interact with a wide range of other medications. Aggrenox should only be used under advice of a doctor, and regular checkups should be attended to monitor for developing complications.

Medical conditions of particular concern include:

• Any bleeding disorders
• Any heart problems
• Kidney or liver impairment
• History of ulcers
• Asthma
• Nasal polyps

Medications of concern include:

• Any other blood thinners
• Any other NSAIDs (ibuprofen, aspirin, etc)
• Diabetes medications
• Seizure medications
• Heart medications
• Blood pressure medications

The above medical issues and medications do not necessarily mean Aggrenox can not be used, but they do put patients at higher risk of complications and patients should be aware of---and alert for---warning signs.

In otherwise healthy patients, the greatest concern with taking Aggrenox is its anti-clotting properties. Bleeding may occur easier and take much longer to clot; this has obvious drawbacks if wounded. Treatment with Aggrenox will need to stop prior to any type of surgery, during pregnancy, and any other scenario in which bleeding is likely. Activities in which injuries are likely---such as contact sports---should be avoided for the duration of treatment.

Fortunately when Aggrenox is used as directed serious side effects are rare. More common side effects, which aren't cause for concern unless severe, include nausea, diarrhea, mild headache, and heartburn. Some patients experience fatigue at the start of treatment. In most cases side effects will stop occurring after a few weeks of treatment.