Aggrenox: Dual-Antiplatelet Protection Against Recurrent Stroke
| Product dosage: 225mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 20 | $2.15 | $43.00 (0%) | 🛒 Add to cart |
| 30 | $1.63 | $64.50 $49.02 (24%) | 🛒 Add to cart |
| 60 | $1.39 | $129.00 $83.42 (35%) | 🛒 Add to cart |
| 90 | $1.20 | $193.50 $108.36 (44%) | 🛒 Add to cart |
| 120 | $1.08 | $258.00 $129.86 (50%) | 🛒 Add to cart |
| 180 | $0.93 | $387.00 $167.70 (57%) | 🛒 Add to cart |
| 270 | $0.77 | $580.50 $208.98 (64%) | 🛒 Add to cart |
| 360 | $0.69
Best per pill | $774.00 $247.68 (68%) | 🛒 Add to cart |
Synonyms | |||
Aggrenox is a prescription medication specifically formulated for secondary stroke prevention in patients who have experienced a prior ischemic stroke or transient ischemic attack (TIA). It represents a sophisticated therapeutic approach, combining two antiplatelet agents—aspirin and dipyridamole—into a single, extended-release capsule. This combination works synergistically to inhibit platelet aggregation through distinct yet complementary mechanisms, offering a robust defense against thrombotic events. By targeting multiple pathways in the coagulation cascade, Aggrenox provides a comprehensive strategy to reduce the risk of subsequent cerebrovascular incidents, making it a cornerstone in neurology and vascular protection protocols. Its carefully engineered delivery system ensures optimal pharmacokinetics for sustained efficacy and patient compliance.
Features
- Each hard capsule contains 25 mg aspirin (acetylsalicylic acid) and 200 mg dipyridamole in an extended-release formulation
- Proprietary combination therapy targeting dual antiplatelet pathways
- Extended-release technology for maintained therapeutic plasma concentrations
- Enteric-coated to minimize gastric irritation
- Standardized dosing regimen of one capsule twice daily
- Available in 60-count and 180-count pharmacy bottles
- Manufactured under current Good Manufacturing Practice (cGMP) standards
- Temperature-stable formulation requiring no special handling
- Clearly marked capsules for identification (opaque yellow, imprinted with “01A”)
- Child-resistant packaging compliant with safety regulations
Benefits
- Significantly reduces relative risk of recurrent stroke compared to aspirin monotherapy
- Provides complementary antiplatelet action through COX-1 inhibition and phosphodiesterase suppression
- Offers convenient twice-daily dosing that supports medication adherence
- Demonstrates superior efficacy to either component administered alone
- Provides sustained platelet inhibition throughout the dosing interval
- Reduces the need for multiple separate medications, simplifying treatment regimens
- Backed by extensive clinical trial data including the landmark ESPS-2 study
- May be appropriate for patients who cannot tolerate higher-dose aspirin regimens
- Supported by major stroke prevention guidelines as an effective option
Common use
Aggrenox is primarily indicated for the secondary prevention of ischemic stroke in patients who have experienced a prior thrombotic cerebrovascular event. It is specifically approved for reducing the risk of stroke in patients who have had transient ischemic attacks (TIAs) or completed ischemic strokes due to thrombosis. The medication is commonly prescribed by neurologists, cardiologists, and vascular specialists as part of a comprehensive stroke prevention strategy. Clinical use typically involves initiation shortly after the acute phase of a stroke or TIA, once the patient is medically stable. It is often considered alongside other antiplatelet options, with selection based on individual patient factors, bleeding risk assessment, and specific clinical circumstances. The therapy is generally intended for long-term management rather than acute treatment.
Dosage and direction
The recommended dosage of Aggrenox is one capsule taken orally twice daily, approximately 12 hours apart. The capsules should be swallowed whole with a full glass of water and should not be crushed, chewed, or opened. Administration with food may help minimize potential gastrointestinal discomfort. The typical dosing schedule is one capsule in the morning and one in the evening, maintaining consistent timing to ensure stable plasma concentrations. Treatment is usually initiated as soon as the patient is medically stable following an ischemic stroke or TIA, typically within weeks of the event. Dosage adjustment is not typically required for elderly patients, but careful monitoring is advised. No dosage alterations are recommended based on gender or race. The capsules should be stored at room temperature and protected from excessive moisture.
Precautions
Patients should be carefully evaluated for bleeding risk before initiating Aggrenox therapy. Caution is advised in patients with history of peptic ulcer disease, gastrointestinal bleeding, or other bleeding disorders. Regular monitoring of complete blood count may be warranted, particularly during the first few months of treatment. Use with caution in patients with severe hepatic impairment, as dipyridamole is extensively metabolized by the liver. Patients with severe renal impairment should be closely monitored due to potential accumulation of metabolites. Aggrenox may cause dizziness; patients should be cautioned about operating machinery or driving until they know how the medication affects them. The aspirin component may trigger bronchospasm in patients with asthma. Patients scheduled for surgical procedures should inform their surgeon about Aggrenox use, as temporary discontinuation may be necessary.
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. Contraindicated in patients with active pathological bleeding such as peptic ulcer disease or intracranial hemorrhage. Should not be administered to patients with severe hepatic impairment or severe renal failure (CrCl <30 mL/min). Not recommended for use in children or adolescents under 18 years due to risk of Reye’s syndrome associated with aspirin. Avoid use in pregnant women, particularly during the third trimester, due to potential adverse effects on fetal cardiovascular system and increased bleeding risk during delivery.
Possible side effects
The most frequently reported adverse reactions involve the gastrointestinal system, including dyspepsia (approximately 15% of patients), abdominal pain (12%), nausea (11%), and diarrhea (8%). Headache occurs in approximately 39% of patients, particularly during initial treatment, though typically diminishes with continued therapy. Bleeding-related events may include ecchymosis (6%), epistaxis (3%), and gastrointestinal bleeding (1-2%). Other reported effects include dizziness (8%), fatigue (5%), and arthralgia (4%). Cardiovascular effects may include hypotension (2%) or tachycardia (1%). Rare but serious adverse reactions include cerebral hemorrhage, severe gastrointestinal bleeding, anaphylactic reactions, and hepatotoxicity. Patients should be instructed to report any signs of bleeding, severe headache, or allergic reactions promptly to their healthcare provider.
Drug interaction
Aggrenox has significant interaction potential due to its dual antiplatelet action. Concomitant use with other anticoagulants (warfarin, heparin), NSAIDs, or other antiplatelet agents increases bleeding risk substantially. ACE inhibitors may have diminished antihypertensive effect when combined with aspirin. Concomitant use with methotrexate increases methotrexate toxicity risk. Aspirin may reduce the effectiveness of probenecid and sulfinpyrazone. Dipyridamole may potentiate the effects of adenosine and other coronary vasodilators. cholinesterase inhibitors may have reduced efficacy when combined with aspirin. Concurrent use with selective serotonin reuptake inhibitors (SSRIs) or SNRIs may increase bleeding risk. Antacids may affect aspirin absorption. Healthcare providers should conduct thorough medication reconciliation before prescribing Aggrenox.
Missed dose
If a dose of Aggrenox is missed, the patient should take it as soon as remembered, 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 dose. Maintaining consistent twice-daily dosing is important for sustained antiplatelet effect, but occasional missed doses are unlikely to significantly impact overall stroke protection. Patients should be educated about the importance of adherence and encouraged to establish a routine (such as pairing doses with morning and evening meals) to minimize missed doses. If multiple doses are missed, patients should contact their healthcare provider for guidance rather than attempting to “catch up” on missed medication.
Overdose
Aggrenox overdose requires immediate medical attention due to the serious nature of its components. Aspirin overdose may manifest as tinnitus, hearing loss, hyperventilation, nausea, vomiting, and metabolic acidosis. Severe overdose can lead to respiratory alkalosis, fever, dehydration, and cerebral edema. Dipyridamole overdose may cause peripheral vasodilation resulting in hypotension, tachycardia, and flushing. Management involves supportive care and symptomatic treatment. Gastric lavage or activated charcoal may be considered if presentation is early. Hemodialysis may be effective for aspirin removal. Specific monitoring should include arterial blood gases, electrolyte levels, and coagulation parameters. Treatment facilities should have capabilities for intensive care management, as severe cases may require respiratory support and correction of acid-base disturbances. There is no specific antidote for Aggrenox overdose.
Storage
Aggrenox capsules should be stored at controlled room temperature between 20°C and 25°C (68°F-77°F), with excursions permitted between 15°C and 30°C (59°F-86°F). The medication must be kept in its original container with the lid tightly closed to protect from moisture. Capsules should not be stored in bathroom cabinets or other areas with high humidity. Keep away from direct sunlight and heat sources. Do not freeze the medication. Always keep Aggrenox out of reach of children and pets, preferably in a locked cabinet. Do not use capsules that show signs of damage, discoloration, or if the expiration date has passed. Proper disposal of unused medication should follow local regulations, typically through drug take-back programs rather than flushing or household trash.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Aggrenox is a prescription medication that should only be used under the supervision of a qualified healthcare professional. The content presented here is not exhaustive and may not include all possible information about this medication. Individual patient responses may vary, and treatment decisions should be based on professional medical judgment considering the patient’s complete medical history and current condition. Patients should always consult with their healthcare provider before starting, stopping, or changing any medication regimen. The manufacturer’s prescribing information should be consulted for complete details regarding use, warnings, and precautions.
Reviews
Clinical studies demonstrate that Aggrenox reduces the relative risk of recurrent stroke by approximately 37% compared to placebo and by 23% compared to aspirin alone, based on the European Stroke Prevention Study 2. Neurologists frequently note its efficacy in high-risk patients, though some report challenges with headache as an initial side effect. Patient reviews often mention appreciation for the convenience of combination therapy but sometimes report gastrointestinal discomfort. The medication receives generally positive evaluation in stroke prevention guidelines, with the American Heart Association/American Stroke Association giving it a Class IIa recommendation for patients with noncardioembolic ischemic stroke or TIA. Cost considerations and insurance coverage sometimes factor into prescribing decisions. Long-term follow-up data support its sustained efficacy in stroke prevention over multiple years of treatment.