Aggrenox: Dual-Antiplatelet Protection Against Recurrent Stroke
Aggrenox
| Product dosage: 225mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 20 | $2.50 | $50.00 (0%) | 🛒 Add to cart |
| 30 | $1.90 | $75.00 $57.00 (24%) | 🛒 Add to cart |
| 60 | $1.62 | $150.00 $97.00 (35%) | 🛒 Add to cart |
| 90 | $1.40 | $225.00 $126.00 (44%) | 🛒 Add to cart |
| 120 | $1.26 | $300.00 $151.00 (50%) | 🛒 Add to cart |
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| 270 | $0.90 | $675.00 $243.00 (64%) | 🛒 Add to cart |
| 360 | $0.80
Best per pill | $900.00 $288.00 (68%) | 🛒 Add to cart |
Synonyms | |||
Aggrenox is a prescription medication specifically formulated to reduce the risk of recurrent ischemic stroke in patients who have experienced a prior stroke or transient ischemic attack (TIA). It combines two active antiplatelet agents—aspirin and dipyridamole—in an extended-release formulation designed to work synergistically. This combination therapy targets distinct pathways of platelet aggregation, offering a comprehensive approach to secondary stroke prevention. By inhibiting clot formation through complementary mechanisms, Aggrenox provides a robust therapeutic option backed by clinical evidence demonstrating significant risk reduction compared to monotherapy approaches.
Features
- Contains a fixed-dose combination of 25 mg aspirin and 200 mg extended-release dipyridamole per capsule
- Utilizes a proprietary extended-release formulation for sustained dipyridamole delivery
- Designed for twice-daily dosing to maintain consistent antiplatelet effects
- Available in bottle configurations of 60 and 120 capsules
- Manufactured under strict pharmaceutical quality control standards
- Features enteric-coated components to minimize gastric irritation
Benefits
- Proven stroke risk reduction: Clinical trials demonstrate up to 37% relative risk reduction in recurrent stroke compared to placebo
- Dual-mechanism protection: Simultaneously inhibits platelet aggregation through both cyclooxygenase-1 and phosphodiesterase pathways
- Synergistic efficacy: Combination therapy provides superior protection compared to either component alone
- Convenient dosing regimen: Twice-daily administration supports patient adherence
- Established safety profile: Extensive clinical experience across diverse patient populations
- Comprehensive vascular protection: May provide additional benefits for patients with other thrombotic risk factors
Common use
Aggrenox is primarily indicated for secondary prevention of ischemic stroke in patients who have experienced a prior cerebrovascular event. It is specifically approved to reduce the risk of recurrent stroke in patients who have had signs or symptoms of ischemic stroke or transient ischemic attack. The medication is typically prescribed as part of a comprehensive vascular protection strategy that may include blood pressure management, cholesterol control, and lifestyle modifications. Healthcare providers often consider Aggrenox for patients who require more aggressive antiplatelet therapy than aspirin alone but may not be candidates for or tolerate other antiplatelet regimens.
Dosage and direction
The recommended dosage of Aggrenox is one capsule taken orally twice daily, approximately 12 hours apart. Capsules should be swallowed whole with a full glass of water and should not be chewed or crushed. Administration with food may help minimize potential gastrointestinal discomfort. The medication is typically taken in the morning and evening, maintaining consistent timing to ensure stable antiplatelet effects. Treatment is usually continued long-term unless significant adverse effects develop or contraindications emerge. Dosage adjustment is not typically required for elderly patients, but careful monitoring is advised in those with renal or hepatic impairment.
Precautions
Patients taking Aggrenox should be monitored for signs of bleeding, including unusual bruising, petechiae, hematuria, or gastrointestinal bleeding. Caution is advised in patients with history of peptic ulcer disease, hepatic impairment, or renal dysfunction. Regular assessment of hemoglobin and hematocrit levels may be warranted during prolonged therapy. The medication may cause dizziness; patients should exercise caution when operating machinery or driving until they understand how the medication affects them. Aggrenox should be used with particular caution in patients with coagulation disorders, severe cardiac disease, or those undergoing surgical procedures. Patients should inform all healthcare providers about their Aggrenox use before any medical or dental procedures.
Contraindications
Aggrenox is contraindicated in patients with known hypersensitivity to aspirin, dipyridamole, or any component of the formulation. It must not be used in patients with asthma, rhinitis, or nasal polyps associated with aspirin or NSAID sensitivity due to risk of severe bronchospasm. Additional contraindications include active peptic ulcer disease, severe hepatic impairment, severe renal failure (CrCl <30 mL/min), and hemorrhagic diatheses. The medication is contraindicated in children and adolescents with viral infections due to association with Reye’s syndrome. Concomitant use with methotrexate at doses greater than 15 mg per week is also contraindicated.
Possible side effects
The most common adverse reactions include headache (approximately 30-40% of patients), dyspepsia (15-20%), abdominal pain (10-15%), and diarrhea (10-15%). Gastrointestinal effects often diminish with continued therapy. Other frequently reported side effects include nausea, vomiting, fatigue, and dizziness. More serious but less common effects include bleeding complications (ranging from minor epistaxis to major hemorrhage), hypersensitivity reactions, hepatitis, and tinnitus. Cardiovascular effects may include hypotension, tachycardia, or chest pain in susceptible individuals. Most side effects are dose-dependent and may be managed through symptomatic treatment or temporary dose reduction under medical supervision.
Drug interaction
Aggrenox exhibits numerous potentially significant drug interactions. Concomitant use with other antiplatelet agents (clopidogrel, prasugrel), anticoagulants (warfarin, dabigatran, rivaroxaban), or NSAIDs increases bleeding risk. Aspirin component may interact with ACE inhibitors, reducing their antihypertensive effect. Concurrent use with methotrexate increases methotrexate toxicity risk. Dipyridamole may potentiate effects of adenosine and other antiarrhythmic agents. Antacids may reduce aspirin absorption. Concomitant use with selective serotonin reuptake inhibitors may increase bleeding tendency. Acetazolamide and valproic acid may displace aspirin from protein binding sites. Healthcare providers should conduct thorough medication reconciliation before initiating therapy.
Missed dose
If a dose of Aggrenox is missed, patients should take it as soon as they remember unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should never take a double dose to make up for a missed one. Consistency in dosing is important for maintaining antiplatelet effects, but occasional missed doses are unlikely to significantly impact overall efficacy. Patients should maintain a regular dosing routine and consider using pill organizers or reminder systems to support adherence. If multiple doses are missed, patients should consult their healthcare provider before resuming therapy.
Overdose
Aggrenox overdose may manifest as symptoms related to either component. Aspirin overdose can cause tinnitus, hearing loss, hyperventilation, nausea, vomiting, dizziness, confusion, metabolic acidosis, and respiratory alkalosis. Severe overdose may lead to coma, cardiovascular collapse, and respiratory failure. Dipyridamole overdose may cause peripheral vasodilation with hypotension, tachycardia, flushing, and dizziness. Management involves immediate medical attention, gastric lavage if presentation is early, activated charcoal administration, and supportive care. Specific measures may include alkaline diuresis for aspirin toxicity and vasopressor support for dipyridamole-induced hypotension. Hemodialysis may be beneficial in severe aspirin overdose cases.
Storage
Aggrenox capsules should be stored at controlled room temperature between 20°C and 25°C (68°F and 77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). The medication must be kept in its original container with the lid tightly closed to protect from moisture and light. Capsules should not be stored in bathroom cabinets or other areas subject to high humidity. Keep out of reach of children and pets. Do not use capsules that show signs of moisture damage, discoloration, or other physical changes. Proper disposal of expired or unused medication should follow local regulations, typically through medication take-back programs.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Aggrenox is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual patient responses may vary, and treatment decisions should be based on comprehensive medical evaluation. The prescribing physician should be consulted for specific recommendations regarding diagnosis, treatment, and monitoring. Patients should not alter their dosage or discontinue medication without medical guidance. While every effort has been made to ensure accuracy, medical knowledge evolves, and newer information may supersede details presented here.
Reviews
Clinical studies demonstrate that Aggrenox maintains consistent efficacy in stroke prevention with an acceptable safety profile. The ESPRIT trial and ESPS-2 study provide robust evidence supporting its use in secondary stroke prevention. Many neurologists report positive experiences with patient outcomes, noting particular benefit in patients who have failed aspirin monotherapy. Some clinicians express concerns about the higher incidence of headache compared to other antiplatelet regimens, though this often resolves with continued use. Patient satisfaction surveys indicate good long-term tolerability when side effects are properly managed. The combination therapy approach receives praise for its mechanistic rationale and demonstrated superiority over single-agent therapy in high-risk populations.