Dipyridamole is a drug that inhibits platelet aggregation and causes vasodilation.

• It inhibits the cellular reuptake of adenosine into platelets, red blood cells and endothelial cells leading to increased extracellular concentrations of adenosine.
• It also inhibits the enzyme adenosine deaminase which normally breaks down adenosine into inosine. This inhibition leads to further increased levels of extracellular adenosine.
• Dipyridamole also inhibits the enzyme phosphodiesterase which normally breaks down cAMP.
• Adenosine interacts with the adenosine receptors to cause increased cAMP via adenylate cyclase.
• cAMP impairs platelet aggregation and also causes arteriolar smooth muscle relaxation.

Modified release dipyridamole is used in conjunction with aspirin (under the trade name Aggrenox®) in the secondary prevention of stroke and transient ischemic attack. This practice is now confirmed by the ESPRIT trial.

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