Why is this drug prescribed?

Aggrenox is prescribed to stave off a stroke in people who have had a "mini-stroke" (transient ischemic attack) or a full-scale stroke due to a blood clot blocking an artery in the brain.

Both the ingredients in Aggrenox prevent the formation of clots by interfering with the tendency of blood platelets to clump together. However, the two ingredients together are more effective at preventing strokes than either ingredient taken alone. Aggrenox doesn't eliminate the possibility of a stroke; but it does reduce the odds by almost six percentage points during the first two years of treatment.

Why Aggrenox is better than aspirin for preventing stroke...
In patients who have had an ischemic stroke or transient ischemic attack (commonly called a TIA or "mini-stroke"), Aggrenox prevents twice as many strokes as aspirin. It contains a unique combination of aspirin and extended-release dipyridamole (die-pih-RID-uh-mole) in a single capsule.

The aspirin in Aggrenox helps prevent platelets from forming clots inside the blood vessels.

The dipyridamole in Aggrenox works in a different way to keep platelets from forming clots.

These two medications, when put together in the Aggrenox capsule, create a powerful antiplatelet combination that helps prevent clots from forming and causing a stroke or TIA.

The most important fact about this drug
Because of the aspirin in Aggrenox, this product cannot be used by people who have an allergy to aspirin and other nonsteroidal anti-inflammatory drugs such as Advil, Motrin, and Naprosyn, or by people who suffer asthma attacks after taking aspirin.

Aggrenox is proven to work
The ability of Aggrenox to prevent stroke recurrence was studied in the largest stroke prevention trial ever—the Second European Stroke Prevention Study (ESPS 2).1,2

This trial was held in 59 centers in 13 Western European countries over a 2-year period. A total of 6602 patients who have had a prior ischemic stroke or transient ischemic attack were studied in the trial.

How should you take this medication?
Aggrenox should be taken once in the morning and once in the evening. The capsule should be swallowed whole without chewing. This drug may be taken with or without food.

If you miss a dose... Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

Storage instructions... Store at room temperature and protect from excessive moisture.

Important Information About Aggrenox:
Aggrenox is indicated to reduce the risk of stroke in patients who have had transient ischemia of the brain or completed ischemic stroke due to thrombosis.

In clinical trials, the most common adverse event with Aggrenox was headache (39.2% vs 32.9% with placebo), which was more frequent at the onset of therapy but diminished over time.3 GI bleeding with Aggrenox was comparable to aspirin (4.1% vs 3.2%) and intracranial hemorrhage with Aggrenox was similar to placebo (0.6% vs 0.4%).

Aggrenox contains aspirin. Patients who consume three or more alcoholic drinks every day should be counseled about the bleeding risks involved with chronic, heavy alcohol use while taking aspirin. Even low doses of aspirin can increase bleeding time, which can adversely affect patients with bleeding disorders. Patients with a history of active peptic ulcer disease should avoid using aspirin, which can cause gastric mucosal irritation and bleeding. Aggrenox should be avoided in the third trimester of pregnancy.

What drug(s) may interact with aspirin-dipyridamole?
•alcohol
•acetazolamide
•alendronate
•antiinflammatory drugs (NSAIDs such as ibuprofen)
•aspirin-containing medicines or other salicylates
•blood thinners (anticoagulants), antiplatelet drugs, or other drugs which may affect bleeding (example: warfarin)
•fish oil (omega-3 fatty acids) supplements
•herbal medicines or dietary supplements like feverfew, garlic pills, ginger, gingko biloba, or horse chestnut
•hormones such as prednisone or cortisone
•medicines for diabetes that are taken by mouth
•medicines for high blood pressure (beta-blockers or ACE inhibitors)
•methotrexate
•medicines for seizures (phenytoin or valproic acid)
•porfimer
•probenecid
•steroids (such as dexamethasone)
•sulfinpyrazone
•vaccines for chickenpox (varicella virus vaccine live)
•water pills (diuretics)

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What form(s) does this medication come in?
Each hard gelatin capsule, with a red cap and an ivory-coloured body, imprinted in red with the Boehringer Ingelheim logo and with "OIA", contains dipyridamole 200 mg as extended-release pellets (a mixture of two release rate pellets) and ASA 25 mg as an immediate-release sugar-coated tablet. Nonmedicinal ingredients include acacia, aluminum stearate, colloidal silicon dioxide, cornstarch, dimethicone, hydroxypropyl methylcellulose, hydroxypropyl methylcellulose phthalate, lactose monohydrate, methacrylic acid copolymer, microcrystalline cellulose, povidone, stearic acid, sucrose, talc, tartaric acid, titanium dioxide, and triacetin. The capsule shell contains gelatin, red iron oxide, titanium dioxide, water, and yellow iron oxide.

What side effects may I notice from taking aspirin-dipyridamole?
Side effects that you should report to your prescriber or health care professional as soon as possible:
•black, tarry stools
•chest pain or palpitations
•confusion
•difficulty breathing, wheezing
•dizziness or fainting spells
•drowsiness or weakness
•pain on swallowing
•redness, blistering, peeling or loosening of the skin, including inside the mouth or nose
•ringing in the ears
•seizures
•skin rash
•stomach pain
•unusual bleeding or bruising, red or purple spots on the skin
•vomiting up blood, or what looks like coffee grounds

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
•diarrhea
•flushing, reddening, or itching of the skin
•headache (if they occur, headaches may occur over time while receiving the drug)
•nausea, vomiting
•reduced amount of urine passed
•stomach gas, heartburn

Aggrenox is not for everyone...
Because Aggrenox contains aspirin, Aggrenox should not be taken by patients with a known allergy to nonsteroidal anti-inflammatory drug (NSAID) products. Some NSAIDs you might be familiar with are acetaminophen, ibuprofen, and naproxen.

It's essential to note that patients with a history of active peptic ulcer disease should avoid taking aspirin products. Even low doses of aspirin can increase the time it takes for the body to form the necessary clots to stop the bleeding in the case of an ulcer. Be sure to alert your doctor if you have an ulcer or if you have any signs of bleeding before you start Aggrenox therapy.

Your doctor may also discuss the bleeding risks associated with chronic, heavy alcohol use while taking aspirin. Aspirin can also increase bleeding risk when used with warfarin or heparin. Again, be sure to tell your doctor if you drink alcohol or if you are taking any of these medications before you start Aggrenox therapy.

Aggrenox contains aspirin. Patients who consume three or more alcoholic drinks every day should be counseled about the bleeding risks involved with chronic, heavy alcohol use while taking aspirin. Even low doses of aspirin can increase bleeding time, which can adversely affect patients with bleeding disorders. Patients with a history of active peptic ulcer disease should avoid using aspirin, which can cause gastric mucosal irritation and bleeding. Aggrenox should be avoided in the third trimester of pregnancy.

What should my health care professional know before I take aspirin-dipyridamole?
They need to know if you have any of these conditions:
•anemia
•asthma
•bleeding or clotting problems
•drink more than 3 alcohol-containing beverages a day
•gout
•kidney disease
•liver disease
•lupus (SLE)
•nasal polyps
•skin problems
•smoke tobacco
•stomach ulcers, or other stomach problems
•thrombotic thrombocytopenic purpura (TTP)
•vitamin K deficiency
•an unusual or allergic reaction to aspirin, dipyridamole, tartrazine dye, other medicines, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

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