Drug Interaction Report

Donanemab-Azbt and Dipyridamole: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Dipyridamole

Permole® Persantine®
+

Donanemab-Azbt

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 19 documented Donanemab-Azbt interactions, 7 are rated moderate — including this one.
Onset
unspecified
Evidence
theoretical
Severity
Moderate

What happens

An increased risk of amyloid related imaging abnormalities (ARIA), or intracerebral hemorrhage

Interaction Deep Dive

Exert caution when donanemab-azbt is coadministered with antiplatelets as it may increase risk for intracerebral hemorrhage and in particular for patients with findings on MRI that are suggestive of cerebral amyloid angiopathy. In a drug interaction study, baseline use of antithrombotic medication (antiplatelets) was allowed. The incidence of ARIA with hemosiderin deposition (ARIA-H) was 30% (106/349) in patients taking donanemab-azbt with a concomitant antithrombotic medication within 30 days compared to 29% (148/504) who did not receive an antithrombotic within 30 days of an ARIA-H event. The incidence of intracerebral hemorrhage greater than 1 cm in diameter was 0.6% (2/349 patients) in patients taking donanemab-azbt with a concomitant antithrombotic medication compared to 0.4% (2/504) in those who did not receive an antithrombotic. The number of events and the limited exposure to non-aspirin antithrombotic medications limit definitive conclusions about the risk of ARIA or intracerebral hemorrhage in patients taking antithrombotic medications1. The Alzheimer's Disease and Related Disorders Therapeutic Workgroup recommends that patients receiving standard doses of antiplatelet agents such as clopidogrel, prasugrel, or ticagrelor be considered as candidates for treatment with donanemab if other use criteria are met 2.

Why it happens (mechanism)

Additive effects on bleeding

Literature reports

2 reports — tap to read

a) The Alzheimer's Disease and Related Disorders Therapeutic Workgroup recommends that patients receiving standard doses of antiplatelet agents such as clopidogrel, prasugrel, or ticagrelor be considered as candidates for treatment with donanemab if other use criteria are met, as there was no elevated risk of amyloid-related imaging abnormalities (ARIA) in patients receiving donanemab and treated with antiplatelet agents in clinical trials 2.

b) In a study, safety was assessed in patients who received donanemab-azbt dosing regimen 1 (n=853) compared to those who received placebo (n=874), baseline use of antithrombotic medication (antiplatelets) was allowed. The incidence of ARIA with hemosiderin deposition (ARIA-H) was 30% (106/349) in patients taking donanemab-azbt with a concomitant antithrombotic medication within 30 days compared to 29% (148/504) who did not receive an antithrombotic within 30 days of an ARIA-H event. The incidence of intracerebral hemorrhage greater than 1 cm in diameter was 0.6% (2/349 patients) in patients taking donanemab-azbt with a concomitant antithrombotic medication compared to 0.4% (2/504) in those who did not receive an antithrombotic. The number of events and the limited exposure to non-aspirin antithrombotic medications limit definitive conclusions about the risk of ARIA or intracerebral hemorrhage in patients taking antithrombotic medications 1.

Common questions

Can I take Donanemab-Azbt and Dipyridamole together?

An increased risk of amyloid related imaging abnormalities (ARIA), or intracerebral hemorrhage Always confirm with your pharmacist or prescriber before making any change.

How serious is the Donanemab-Azbt and Dipyridamole interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Donanemab-Azbt or Dipyridamole need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (2)

  1. Product Information: KISUNLA(TM) intravenous injection, donanemab-azbt intravenous injection. Eli Lilly and Company (per FDA), Indianapolis, IN, 2025. DailyMed
  2. Rabinovici GD, Selkoe DJ, Schindler SE, et al: Donanemab: appropriate use recommendations. J Prev Alzheimers Dis 2025; 12(5):100150. PubMed
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Beyond drug–drug

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.