Dipyridamol opbouw in secundaire preventie van beroerte.

The ESPS2 (1996) and ESPRIT (2006) studies have proven that secondary preventive therapy with acetylsalicylic acid combined with dipyridamole is more effectiev preventive therapy after stroke than treatment with one of the components. Headache is a frequent side-effect of dipyridamole. Dose escalation helps to reduce this side-effect. National and international guidelines state that dipyridamole dose has to be escalated gradually, but non of the guidelines mentions a dose escalation scheme. In practice different hospitals use different schemes. There is no research that indicates the best dose escalation scheme.

Treatment starting with a low dose dipyridamole reduces the side-effect headache with 25%.

Patients fill out a diary on day 1, 3, 5, 7, 14, 21 and 28 of the study period.

Two study arms, 4 weeks medication.

Both arms: Two weeks acetylsalicylic acid 160 mg once daily and week 3 and 4 80 mgs once daily. Further:

1. Week 1 and 2, 200 mgs dipyridamole retard once daily. Week 3 and 4 dipyridamole retard 200 mgs twice daily;

2. Week 1, 75 mgs dipyridamole once daily. Week 2, 75 mgs dipyrdidamole twice daily. Week 3, 200 mgs retard once daily and week 4 200 mgs retard twice daily.