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What is your opinion about my father's medication?

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What is your opinion about my father's medication?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At November 5, 2016
Reviewed AtAugust 1, 2023

Patient's Query

Hi doctor,

My father had a stroke before 10 years (left hemisensory infarct) and two years ago, he has undergone coronary artery bypass graft (CABG). Two days back, while walking, he felt some numbness in his right side leg and arm up to the shoulder. It persisted for about half an hour. Now, he is fine. But, when we visited the doctors, they suspected a transient ischemic attack (TIA). They have made some changes to his medicines. He was taking Clopilet 75 mg and Ecosprin 150 mg once daily, which they have changed to Arreno (Aspirin and Dipyridamole - 25/200 mg) two times a day and Ecosprin 75 mg once a day. Is this better? Can he take Arenno and Ecosprin 75 together in the morning instead of taking Ecosprin 75 in the afternoon as there is a change to forget? His current medications are Mixtard Insulin 30/70 - 38 units in the morning and 15 units at night, Glycomet GP2 one tablet in the morning and one at night, Linagliptin 5 mg, Fibator 10 mg, Metolar 25, Dynapres 0.4, Arreno, Ecosprin 75 mg and Thyronorm 25 mg one tablet on weekdays and two tablets on weekends.

Hi,

Welcome to icliniq.com. Yes, he can follow the changed schedule. Your doctor has changed plain Aspirin and Clopilet (Clopidogrel) to the combination of Aspirin and Dipyridamole. Dipyridamole is a medicine, which is quite effective in preventing the thrombosis. It is more effective on the coronary heart arteries than the brain. It has a short period of action, so they have given it twice a day. Having a history of CABG (coronary artery bypass graft), they would have added the Dipyridamole in the prescription. He can take both Arreno and Ecosprin (Aspirin) together and no harm as such. But, the word of caution here is that both have Aspirin in it and that can produce some gastric irritation or acidity.

Patient's Query

Thank you doctor,

Is Dipyridamole more effective than Clopilet? Will it take care of both heart and brain? His Aspirin new dose is now 125 instead of 150, which is the earlier dose. I hope that will not make a difference. His platelet count usually remains 1.4 to 1.5 lakhs. I hope the new medicine will not bring it down further. Please clarify.

Hi,

Welcome back to icliniq.com. Regarding Aspirin dose, the latest studies have proven that anything above 75 mg per day of Aspirin is good enough to prevent abnormal blood clotting. Regarding Dipyridamole versus Clopilet, it is difficult to give absolute judgement. Both have their own advantages and disadvantages. But, one significant positive point aboutDipyridamole is that it is short acting and it does not act on the platelets directly. It halts the mechanism, which is involved in platelet aggregation. The effect of Dipyridamole is short acting, while the cumulative effect of Clopilet on platelet is at least 7 days to a maximum of 21 days. This long action of Clopilet increases the chance of abnormal bleed in the brain. We do see a lot of chronic subdural hematoma patients who are on both Aspirin and Clopilet.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hardik Nareshbhai Rajyaguru
Dr. Hardik Nareshbhai Rajyaguru

Neurology

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