Dipyridamole

Popular Brand Names:

Persantin Persantine Curantyl

The drug dipyridamole has been in clinical use since 1961. In the US and Europe, it is used to inhibit blood clotting in patients who have several medical conditions. It’s normally used for prolonged periods of time, sometimes for 20 years or more. In Russia, dipyridamole is also approved for use as an antiviral agent. The drug is used in treating all age groups, from children through to elderly people.

In the US, dipyridamole is also sold as Aggrenox, which is a combination of 25 mg of aspirin and 200 mg of extended-release dipyridamole, usually prescribed twice a day to reduce the risk of strokes.

The potential of dipyridamole as an effective treatment for SARS-CoV-2, the virus which causes COVID-19, was discovered by Dr. Hai-Bin Luo of the School of Pharmaceutical Sciences, Sun Yat-sen University, in Guangzhou, China. Dr. Luo used virtual computer modeling to identify dipyridamole as a drug with the potential to target a key protein required for SARS-CoV-2 replication.

Subsequently, the first clinical trial in COVID-19 patients was undertaken in early 2020 by Drs. Hai-Bin Luo, Fuling Zhou, Yuxia Zhang, Xuechuan Hong, and Juncun Zhao and colleagues, at several hospitals in China.

Dipyridamole is considered a pleiotropic drug, which means it has multiple unrelated effects on the body. It has off-label uses in over 25 medical conditions.

Key Facts for Dipyridamole

Description: Antiplatelet Agent
Year Approved: 1961
Approved Uses:

Thromboembolism prophylaxis (US),
Prophylaxis of deep vein thrombosis (UK),
Antiviral (Russia)

Typical Dose Range: 75mg to 600mg / daily
Maximum Reported Safe Dose in Adults: 600mg / daily
Populations of Use: Pediatric, Adult, Geriatric
Typical Duration of Use: Long Term
Further Drug Information: medicine.com

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Dipyridamole's Anti-COVID Properties

  • Antiviral activity against SARS-CoV-2
  • Binds to SARS-CoV-2 protease Mpro (a key protein required for the virus to replicate)
  • Upregulates adenosine A2A receptor signaling, which results in anti-inflammatory effects and reduced blood clotting, lowering the risk of thrombosis.
  • Anti-inflammatory
  • Anti-oxidant
  • Dilates blood vessels to improve blood flow
  • Cardioprotective
  • Renoprotective – protects kidney function
  • Neuroprotective – reduces neuroinflammation
  • Endothelial-protective – endothelial cells affect blood vessel contraction and relaxation as well as blood clotting, immune function and platelet adhesion.
  • Anti-fibrotic – fibrosis is the development of fibrous connective tissue in response to injury or damage.
  • Increases production of the antiviral protein, interferon.
  • Suppresses IgG-induced neutrophil extracellular trap (NET) release.

Published Medical Literature About Dipyridamole’s Role in COVID

Access all Research

July 23, 2021 | Peer Reviewed: No | Publication Type: Review/Commentary/Letter

Dipyridamole may block COVID-19 induced blood clotting and inflammation firestorms.

New (re)purpose for an old drug: purinergic modulation may extinguish the COVID-19 thromboinflammatory firestorm
May 1, 2021 | Peer Reviewed: Yes | Publication Type: Original , Preclinical

According to computer simulations, dipyridamole targets the main replication protein of SARS-CoV-2, called Mpro.

An Integrative in silico Drug Repurposing Approach for Identification of Potential Inhibitors of SARS-CoV-2 Main Protease
March 1, 2021 | Peer Reviewed: Yes | Publication Type: Review/Commentary/Letter

A review of the role of dipyridamole in treating COVID-19.

A REVIEW ON THE THERAPEUTIC POTENTIAL OF DIPYRIDAMOLE IN THE TREATMENT OF COVID-19
February 23, 2021 | Peer Reviewed: Yes | Publication Type: Original , Preclinical

Study shows that dipyridamole is not a strong inhibitor of the SARS-CoV-2 main protease, Mpro.

Dipyridamole, chloroquine, montelukast sodium, candesartan, oxytetracycline, and atazanavir are not SARS-CoV-2 main protease inhibitors

Videos Discussing Dipyridamole’s Role in COVID

SPARK Drug Repurposing Conference Tel Aviv University Oct 2020

MedInsight Research Institute | October 26, 2020

Generic Drug Repurposing for Covid-19. A conference hosted by Tel Aviv University, SPARK Tel Aviv, and the MedInsight Institute. Dipyridamole is one of the drugs discussed at this conference.


Clinical Trials of Dipyridamole in COVID

August 18, 2020 | Hospital-Based |

Evolution of COVID-19 in Anticoagulated or Antiaggregated Patients

Chronic antiplatelet therapy (aspirin, clopidogrel, prasugrel, ticagrelor, cangrelor, dipyridamol) for any indication (dose and frequency not stated)

June 11, 2020 | Hospital-Based |

A Randomized, Open-label Study of the Vascular and Microbiologic Efficacy of Dipyridamole Plus Standard Care vs. Standard Care in Hospitalized COVID19 Patients

100mg taken 3 times a day by mouth for 7 days

June 1, 2020 | Hospital-Based |

A Randomized Controlled Trial to Evaluate the Outcomes With Aggrenox in Patients With SARS-CoV-2 Infection

Dipyridamole ER 200mg/ Aspirin 25mg orally/enterally

May 18, 2020 | Hospital-Based |

Dipyridamole to Prevent Coronavirus Exacerbation of Respiratory Status (DICER) in COVID-19

100 milligrams (mg) by mouth (PO) four times a day (QID) given for 14 days while in the hospital.

February 22, 2020 | Hospital-Based |

Multicenter study for the treatment of Dipyridamole with novel coronavirus pneumonia (COVID-19)

Dose and frequency not stated