NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Dipyridamole MR Supply Issues

Dipyridamole 200mg MR is currently subject to supply disruptions, with no definitive date as to when or if the situation will be resolved.

Persantin Retard® (dipyridamole 200mg MR) has been discontinued by the manufacturers, with the last batch due to be in wholesalers in early August, thereafter there will be no further stock of the brand. There are currently only two generic manufacturers and they will continue to market dipyridamole 200mg MR capsules.  They are also experiencing supply issues and do not expect stock to be available until mid-September 2018 at the earliest. As supplies are likely to be sporadic in the medium term, the following is recommended by NHSGGC stroke specialists:

  • There is no evidence for the use of standard release dipyridamole 100mg in secondary prevention of ischaemic stroke and transient ischaemic attacks.  Additionally, dipyridamole 100mg tablets need to be taken three times a day and are not licensed for the same indication as the 200mg MR capsules.
  • Clopidogrel is considered first line therapy for secondary prevention of ischaemic stroke and transient ischaemic attacks. Refer to GGC guideline on StaffNet here. Clopidogrel is tolerated by the majority of patients; the most common reasons for non-compliance are GI side effects and rashes.
  • It is recommended that all patients prescribed dipyridamole 200mg MR should be reviewed, with a view to switching appropriate patients medication to clopidogrel 75mg daily. If on aspirin and dipyridamole, aspirin should be stopped prior to starting clopidogrel monotherapy.
  • For patients with previous mild intolerance to clopidogrel, consider trial resumption of clopidogrel with appropriate therapy for management of side effect symptoms.
  • Aspirin dispersible 75mg once daily should be used if both clopidogrel and dipyridamole MR are contraindicated, not tolerated or are unavailable.
  • If patients are on dipyridamole for other indications, refer back to the specialist.

 

Published 20/08/18