Is given, the addition of ACE inhibitors Dexrazoxane Totect increase the added value generated in any big vascular en Ren events. Therefore, in the absence of clear indications-cons, the concomitant use of aspirin and ACE inhibitors in all patients at high risk of serious vascular Re events are considered. 147 2.0 2.1 mechanism of action is a derivative of dipyridamole dipyridamole pyrimidopyrimidine with vasodilator and antiplatelet properties. The mechanism of action of dipyridamole as Antipl Ttchen agent is controversial. 148 Both the inhibition of cyclic nucleotide phosphodiesterase and blockade of the uptake of adenosine have been proposed. In addition, the direct stimulation of the synthesis of PGI 2 and the protection have been reported against the deterioration, although the dipyridamole concentrations required to produce these effects far Herk over the low micromolar plasma levels after oral administration of Achieved mmlichen doses. Dipyridamole also inhibits the 148 differentially expressed genes critical infl ammatory plateletleukocyte of aggregates. 149 2.2 Pharmacokinetics The absorption of dipyridamole from conventional formulations is quite variable and appeared to have dinner low systemic bioavailability of the drug. A modified formulation of dipyridamole with improved bioavailability edrelease was developed in a combination pill with low-dose aspirin. 150 Dipyridamole is highly bound to albumin, especially bili Ren excretion of glucuronide excreted and is subject to enterohepatic circulation. A terminal half-life of 10 h were reported. This is used in accordance with the pattern of presentation in recent clinical trials. 2.3 effi ciency and effectiveness of security, the clinical efficacy of immediate-release dipyridamole alone or in combination with aspirin, on the basis of randomized studies, more tt put into question. 3151 Therefore, the formulation with extended Ngerter latest release in the ESPS 2 reformulated, aspirin and dipyridamole versus aspirin alone after cerebral ish Chemistry of arterial origin and Pr Prevent effective prevention regime, that the second Strokes evaluated randomized trials. In ESPS 2, the new formulation of dipyridamole in 6602 patients with stroke or TIA has been evaluated before. 40 This study showed that the addition of dipyridamole to aspirin Ver changed Edrelease with a relative risk reduction of 22% of serious vascular Re connected events compared with aspirin monotherapy. Headache was the hour Most frequent side effect of dipyridamole. In ESPRIT, patients were 152 2739 within 6 months after a TIA or minor stroke of presumed arterial origin were randomized aspirin received, with or without dipyridamole. Compared to aspirin alone, the prime Re endpoint was reduced by 20% with combination therapy. In patients receiving aspirin and dipyridamole discontinued if drug trials Fter than the almostthree on aspirin alone, especially because of the headaches. 152 In the PRoFESS study, 153 20 332 patients with acute isch were Mix of stroke were randomized to the combination of aspirin and extended release dipyridamole or clopidogrel for an average of 2.5 years. The High Representative Pemetrexed for the effi ciency could reach the main result of non-inferiority margin prespecifi ed. Major bleeding was h More common in people given aspirin, extended-release dipyridamole in more p.