Dipyridamole with Ginger Interaction Details
Brand Names Associated with Dipyridamole
- Dipyridamole
- Permole®
- Persantine®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 08, 2024
Interaction Effect
Increased risk of bleeding
Interaction Summary
Theoretically, the possible antiplatelet effect of ginger may increase the risk of bleeding when combined with an antiplatelet agent. Clinical trials have demonstrated a significant effect on platelet aggregation only following a single oral dose of 10 grams of powdered ginger, a higher dose than that usually used . Clinical trials using smaller daily doses of raw ginger, cooked ginger, and dried ginger have not shown a significant effect on platelet aggregation . Ginger extract did not significantly alter blood coagulation parameters either alone or in combination with warfarin in rats . In vitro data demonstrate that ginger may inhibit platelet aggregation . The extraction method used may significantly affect the ability of ginger to inhibit platelet aggregation .
Severity
Minor
Onset
Rapid
Evidence
Theoretical
How To Manage Interaction
The clinical significance of any effect ginger may have on platelet aggregation is undetermined. Caution is advised if ginger and an antiplatelet agent are taken concomitantly. Studies suggest that over 4 grams of dried or 15 grams raw ginger root daily must be ingested in order to have any effect on blood coagulation.
Mechanism Of Interaction
Additive antiplatelet effects; ginger may inhibit thromboxane B2 formation and thromboxane synthetase and increase prostacyclin levels
Literature Reports
A) Powdered ginger significantly inhibited platelet aggregation in a placebo-controlled study of 20 patients with coronary artery disease. Patients received powdered ginger, 10 grams as a single dose. Ginger reduced adenosine diphosphate (ADP)- and epinehrine-induced platelet aggregation (p less than 0.05). The platelet response appears to be dose-dependent, as ginger 4 grams daily for 1.5 and 3 months did not exert any appreciable effect on platelet aggregation, fibrinogen, or fibrinolytic activity. All patients had a history of myocardial infarction greater than 6 months old, and all were taking nitrates and aspirin. Aspirin was discontinued 2 weeks prior to the study .
B) Raw ginger root had no significant effect on platelet function in 18 healthy volunteers in a randomized, placebo-controlled crossover study. Subjects received either raw Brazilian ginger root 15 grams, cooked stem ginger 40 grams, or placebo for 2 weeks. Subjects discontinued use of any medications for 1 month prior to the study. The mean decrease in thromboxane production was 1 +/- 9% for ginger root and 1 +/- 8% for stem ginger as compared to placebo (p=0.984). Mean thromboxane B2 production was unchanged .
C) Dried ginger did not affect platelet function in a randomized, double-blind, placebo-controlled study of 8 healthy male subjects. Subjects received 2 grams dried ginger. The change in bleeding time in the ginger group was not significant, but bleeding time was somewhat less after ginger use than pre-treatment or placebo. Ginger did not significantly inhibit aggregation induction ex vivo by either ADP, ristocetin, arachidonic acid, or collagen 3 and 24 hours after consumption .
Dipyridamole Overview
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Dipyridamole is used with other drugs to reduce the risk of blood clots after heart valve replacement. It works by preventing excessive blood clotting.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.