aspirin / dipyridamole ER
Aggrenox (aspirin / dipyridamole) is a combination of two antiplatelet medications. It's taken to lower the risk of having a stroke if you've had one before, whether it was an ischemic stroke or a transient ischemic attack (TIA, also called a "mini stroke").
What is Aggrenox (aspirin / dipyridamole)?
What is Aggrenox (aspirin / dipyridamole) used for?
Stroke prevention for people who've had an ischemic stroke (due to blood clots)
Stroke prevention for people who've had a transient ischemic attack (TIA, or "mini stroke")
How Aggrenox (aspirin / dipyridamole) works
Aggrenox (aspirin / dipyridamole) contains two antiplatelet medications: aspirin and dipyridamole. They work by blocking your platelets from clumping up together and forming blood clots. This helps to lower your risk for clots that block blood and oxygen from getting to your brain. As a result, Aggrenox (aspirin / dipyridamole) can help to lower your risk for a stroke.
Drug Facts
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What are the side effects of Aggrenox (aspirin / dipyridamole)?
Common Side Effects
- Headache (28%)
- Indigestion (13%)
- Stomach pain (13%)
- Nausea (12%)
- Diarrhea (9%)
Other Side Effects
- Vomiting
- Bleeding
Serious Side Effects
- Serious bleeding: feeling faint or lightheaded, dizziness, vomiting blood, bloody or dark-colored stools, severe stomach pain
- Liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion
- Kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
- Very low blood pressure: dizziness, lightheadedness, faint, tiredness, confusion
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Chest pain (angina)—pain, pressure, or tightness in the chest, neck, back, or arms
- Hearing loss, ringing in ears
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Round red or dark patches on the skin that may itch, burn, and blister
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Headache
- Loss of appetite
- Nausea
- Stomach pain
- Upset stomach
Pros and cons of Aggrenox (aspirin / dipyridamole)
Pros
A first-choice option for lowering the risk of having another stroke if you've had one before
Works better than aspirin alone to prevent strokes
More convenient to take two medications in a single capsule
Can take with or without food
Cons
Commonly causes headache and stomach side effects
Need to take twice per day
Can't use if you're allergic to aspirin or NSAIDs like ibuprofen (Advil, Motrin) or naproxen (Aleve)
Not well studied in pregnant or breastfeeding females, so it's not completely known how safe it is for unborn or breastfed babies
Pharmacist tips for Aggrenox (aspirin / dipyridamole)
Take Aggrenox (aspirin / dipyridamole) twice per day about 12 hours apart and at the same times each day. You can take the medication with or without food.
Swallow the capsule whole. Don't crush, chew, or open the capsule because this can affect how much medication gets absorbed into your body. Contact your provider if you're having trouble swallowing the capsules.
Headache is a common side effect of Aggrenox (aspirin / dipyridamole). But it usually goes away after taking the medication consistently for some time. If you continue to have headaches or if they're very bothersome, contact your provider for recommendations on how to manage them.
Aggrenox (aspirin / dipyridamole) can raise the risk of stomach bleeding. So tell your provider right away if you experience unexplained stomach pain, dark-colored stools, or blood in your vomit or stool.
Make sure to tell your provider about all the medications you're taking. This is especially important if you're taking antiplatelets or anticoagulants because you're at higher risk of bleeding when you take these medications with Aggrenox (aspirin / dipyridamole). Talk to your provider or pharmacist to make sure all your medications are safe to take with Aggrenox (aspirin / dipyridamole).
Don't take Aggrenox (aspirin / dipyridamole) with other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Doing so puts you at higher risk for stomach bleeds, stroke, and heart attack. NSAIDs are commonly found in over-the-counter pain and cold medications. Talk with your healthcare provider or pharmacist if you're not sure whether you're already taking an NSAID.
In addition to taking Aggrenox (aspirin / dipyridamole), there are some lifestyle changes that you can do to help lower your risk for stroke even more. These recommendations include having a healthy and balanced diet and a regular exercise routine.
Store Aggrenox (aspirin / dipyridamole) up and away from children so they're less likely to reach and accidentally take the medication. If you think your child accidentally took the medication, call a Poison Control Center at 1-800-222-1222 or get medical help right away. Children with viral infections who take aspirin-containing medications might be at risk of a potentially serious condition called Reye's syndrome.
Frequently asked questions about Aggrenox (aspirin / dipyridamole)
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What are the risks and warnings for Aggrenox (aspirin / dipyridamole)?
Aggrenox (aspirin / dipyridamole) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Bleeding
Risk factors: Taking other blood thinners | Taking NSAIDs long term | History of stomach bleeding or ulcers | Drinking 3 or more alcoholic drinks a day
Aggrenox (aspirin / dipyridamole) raises your risk for bleeding. Additionally, this medication might make it take longer than usual for any bleeding to stop. You might also notice that you get bruises more easily or have more bleeding when you get a cut or nosebleed. Although rare, bleeding into other organs, such as those in the digestive tract, is also possible. To lower your risk for bleeding, tell your provider about all of your medications and medical conditions before starting Aggrenox (aspirin / dipyridamole). Try to limit alcohol intake as much as possible. If you feel faint, lightheaded, or dizzy; vomit blood; have bloody or dark-colored stools; or feel severe stomach pain; stop taking Aggrenox (aspirin / dipyridamole) and get medical attention right away.
Kidney or liver problems
Risk factors: History of kidney or liver problems
Though rare, Aggrenox (aspirin / dipyridamole) might cause kidney or liver problems that can sometimes be life-threatening. This might be more likely if you take higher than recommended doses of Aggrenox (aspirin / dipyridamole). To be safe, let your provider know of your medical history before starting this medication. Avoid Aggrenox (aspirin / dipyridamole) if you already have severe kidney or liver damage. Get medical attention right away if you notice stomach bloating; stomach pain; yellowing of your skin or the whites of your eyes; stool changes (black, tarry, or bloody stools); dark, brown, foamy, or bloody urine; you're urinating less than usual, or muscle cramps. You might need to stop using the medication to prevent further kidney or liver damage.
Low blood pressure
Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Taking other medications that can lower your blood pressure | History of low blood pressure
Aggrenox (aspirin / dipyridamole) can cause your blood pressure to drop too much. This can make you feel dizzy, tired, or lightheaded. Your risk is higher if you're dehydrated or have medical conditions, such as diarrhea or vomiting, that cause you to become dehydrated. Make sure to drink plenty of fluids. If you feel dizzy, lightheaded, faint, or tired, sit down slowly while holding onto something to prevent falling, and let your provider know. If you feel confused or fall and hit your head, get medical help right away.
Allergic reactions
Risk factors: Aspirin or NSAID allergy
Allergic reactions to Aggrenox (aspirin / dipyridamole) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis. Let your provider know if you have an allergy to aspirin or other NSAIDs before starting Aggrenox (aspirin / dipyridamole). If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using Aggrenox (aspirin / dipyridamole), get medical attention right away.
Aggrenox (aspirin / dipyridamole) dosage forms
Typical dosing for Aggrenox (aspirin / dipyridamole)
The typical dose is 1 capsule by mouth twice per day (once in the morning and once in the evening).
Each capsule of Aggrenox (aspirin / dipyridamole) contains 25 mg of aspirin and 200 mg of extended-release dipyridamole.
How much does Aggrenox (aspirin / dipyridamole) cost?
Aggrenox (aspirin / dipyridamole) contraindications
Allergy to aspirin or another NSAID
Asthma, nose inflammation, or nasal polyps
Children younger than 18 years old with an active viral infection
What are alternatives to Aggrenox (aspirin / dipyridamole)?
Stroke prevention for people who've had an ischemic stroke (due to blood clots)
Stroke prevention for people who've had a transient ischemic attack (TIA, or "mini stroke")
Heart attack prevention
Stroke prevention
What is the latest news about Aggrenox (aspirin / dipyridamole)?
Aggrenox (aspirin / dipyridamole) images
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References
Best studies we foundAmerican Red Cross. (n.d.). Platelets and thrombocytopenia.
Micro Labs Limited. (2022). ASPIRIN AND EXTENDED-RELEASE DIPYRIDAMOLE capsule, extended release [package insert].
Kleindorfer, D. O., et al. (2021). 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke.
Verro, P., et al. (2008). Aspirin plus dipyridamole versus aspirin for the prevention of vascular events after stroke or TIA. Stroke.
Theis, J. G. W., et al. (1999). Rapid development of tolerance to dipyridamole-associated headaches. British Journal of Clinical Pharmacology.
National Kidney Foundation. (n.d.). Pain medicines (analgesics).
National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Aspirin. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury.
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