Extended-release dipyridamole/aspirin

The fixed-dose combination of extended-release dipyridamole/aspirin (Aggrenox/Asasantin Retard) combines 2 antiplatelet agents with different mechanisms of action. The combination reduced thrombus formation in human and animal models. Coadministration of extended-release dipyridamole and aspirin in healthy volunteers had no significant effects on the plasma concentrations of either agent. Twice-daily oral extended-release dipyridamole/aspirin (400/50 mg/day) was twice as effective as either agent alone in the secondary prevention of stroke in a large clinical trial involving patients with prior stroke or transient ischaemic attack. The rate of the combined end-point of stroke and death tended to be lower with the combination than with other treatments. The incidence of death was not significantly reduced by any treatment. Most adverse events with extended-release dipyridamole/aspirin were mild and similar to those with either agent alone. Bleeding was more common with the combination than with extended-release dipyridamole alone, as was headache when compared with aspirin alone. Limited pharmacoeconomic analyses suggest that treatment with extended-release dipyridamole/aspirin was cost saving and was cost effective compared with aspirin monotherapy for the secondary prevention of stroke.