Persantine

Persantine is the brand name for dipyridamole, a coronary vasodilator and antiplatelet agent used in cardiology. Dipyridamole inhibits phosphodiesterase in platelets, increasing cyclic AMP, which inhibits platelet aggregation. It also relaxes vascular smooth muscle, particularly in coronary arteries, leading to increased blood flow and a phenomenon sometimes described as coronary steal.

Clinical uses include pharmacologic stress testing for myocardial perfusion imaging in patients who cannot exercise adequately. Dipyridamole induces coronary vasodilation, and when combined with imaging, can reveal perfusion defects indicative of ischemia. In some regions, dipyridamole is used as part of long-term antiplatelet therapy in combination with aspirin, notably in regimens marketed as Aggrenox for stroke prevention.

Administration details vary by indication. Persantine is available in oral and intravenous forms. During pharmacologic stress testing, dosing is coordinated with the imaging protocol, with careful monitoring for adverse effects.

Common side effects include headache, dizziness, flushing, chest discomfort, and hypotension. Nausea and abdominal discomfort may occur. A notable risk during stress testing is the coronary steal effect, which can worsen ischemia in certain patients with multivessel disease. Patients are generally advised to avoid caffeine for about 24 hours before testing, as caffeine can antagonize dipyridamole’s effects and reduce test sensitivity.

Contraindications include known hypersensitivity to dipyridamole and conditions that predispose to significant hypotension or worsen vasodilation. Dipyridamole can interact with caffeine and other adenosine-modulating substances, and with drugs that affect blood pressure.