Dipyridamole
證據等級: L5 | 預測適應症: 10 個
## 藥師評估報告
Dipyridamole (待乙妥) - 藥師評估報告
一句話總結
Dipyridamole 是一種磷酸二酯酶抑制劑和腺苷再攝取抑制劑，用於心絞痛和血栓預防；TxGNN 預測其對變異型心絞痛和中風有潛在療效，有豐富的臨床試驗和文獻支持，但變異型心絞痛預測與原適應症高度重疊。
快速總覽
| 項目 | 內容 |
|---|---|
| 藥物名稱 | Dipyridamole (待乙妥/雙乙妥) |
| DrugBank ID | DB00975 |
| 台灣商品名 | 百心康、Aggrenox（與 aspirin 複方） |
| 原適應症 | 慢性狹心症、冠狀動脈不全、血小板凝集降低、心肌灌流造影替代運動試驗 |
| 預測新適應症 | Prinzmetal angina、stroke disorder、thrombotic disease、atrial fibrillation (disease)、sick sinus syndrome 2, autosomal dominant、transient ischemic attack (disease)、sarcoglycanopathy、Wildervanck syndrome、macrocephaly, dysmorphic facies, and psychomotor retardation、lateral sinus thrombosis |
| 最高 TxGNN 分數 | 0.9999 (Prinzmetal angina) |
| 臨床試驗支持 | 豐富 (中風預防) |
| 文獻支持 | 豐富 |
預測適應症詳細分析
1. Prinzmetal angina L4 99.99% 主要分析
為什麼這個預測合理？
### 機轉分析
- 變異型心絞痛 (Prinzmetal angina)：
- TxGNN 分數 0.9999，排名 438
- Dipyridamole 是冠狀動脈血管擴張劑
- 理論上可緩解冠狀動脈痙攣
- 但文獻顯示其對變異型心絞痛的效果不一，部分研究甚至指出無效或可能加重症狀
- 注意：此預測與原適應症「慢性狹心症」高度重疊
- 中風 (stroke disorder)：
- TxGNN 分數 0.9995，排名 1695
- Dipyridamole 抑制血小板凝集
- 與 aspirin 合用已被廣泛用於缺血性中風的二級預防
- 重要：Aggrenox (dipyridamole + aspirin) 已是核准適應症
臨床試驗
目前無針對此特定適應症的臨床試驗登記。
相關文獻
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 633593 | 1978 | Article | Japanese circulation journal | Pathogenesis and treatment of angina pectoris at rest as seen from its response ... |
| 3421166 | 1988 | Article | The American journal of cardio | Aminophylline termination of dipyridamole stress as a trigger of coronary vasosp... |
| 3190956 | 1988 | Article | British heart journal | Short term reproducibility of exercise testing in patients with ST segment eleva... |
| 16630456 | 2006 | Article | Zhonghua xin xue guan bing za | [Clinical features of patients with atypical coronary artery spasm]. |
| 8417062 | 1993 | Article | Journal of the American Colleg | Increased echodensity of transiently asynergic myocardium in humans: a novel ech... |
| 8634169 | 1996 | Article | Revista portuguesa de cardiolo | [The 3-year prognosis of patients with suspected coronary disease and a normal m... |
| 6779029 | 1981 | Article | Japanese circulation journal | Noninvasive detection of coronary artery disease by myocardial imaging with thal... |
| 6125623 | 1982 | Article | Kardiologiia | [Current diagnostic and treatment problems in stenocardia]. |
| 3915223 | 1985 | Article | Cardiologia (Rome, Italy) | [Effects of other provoking tests on cardiovascular function]. |
| 7628141 | 1995 | Article | Clinical nuclear medicine | Is cardiac migraine a clinical entity? |
| 6775030 | 1980 | Article | The Journal of the Indiana Sta | The five fingers of cardiology. |
| 2022043 | 1991 | Article | Circulation | Pathophysiological basis for noninvasive functional evaluation of coronary steno... |
| 2221701 | 1990 | Article | Annals of the New York Academy | Electrocardiographic diagnosis of transient myocardial ischemia. Sensitivity, sp... |
| 14050937 | 1963 | Article | Naika. Internal medicine | [4 CASES OF A VARIANT FORM OF ANGINA PECTORIS]. |
| 14060538 | 1963 | Article | Naika. Internal medicine | [CASE OF VARIANT FORM OF ANGINA PECTORIS]. |
2. stroke disorder L1 99.95%
臨床試驗（31 項）
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT02966119 | PHASE3 | TERMINATED | 23 | Evaluation of the Benefit/Risk Ratio of Restarting or Avoiding Antiplatelet Drug... |
| NCT01781611 | NA | TERMINATED | 18 | Dipyridamole Assessment for Flare Reduction in SLE |
| NCT06983795 | N/A | NOT_YET_RECRUITING | 1000 | Pioneering Advancements in Cardiocerebrovascular Interactions in the Asia pacFIC... |
| NCT01528800 | PHASE2 | COMPLETED | 85 | Inhibit Progression of Coronary Artery Calcification With Vitamin K in HemoDialy... |
| NCT03993119 | N/A | COMPLETED | 500 | Non-Interventional, Cross-sectional Study to Describe NOACs Management in Elderl... |
| NCT00134433 | PHASE1, PHASE2 | COMPLETED | 20 | Endothelial Modulation With L-Arginine in Patients Undergoing Angiogenic Therapy... |
| NCT00738894 | NA | COMPLETED | 664 | GORE® HELEX® Septal Occluder / GORE® CARDIOFORM Septal Occluder and Antiplatelet... |
| NCT00562588 | PHASE4 | COMPLETED | 551 | EARLY: Prospective, Randomised, National, Multi-centre, Open-label, Blinded Endp... |
| NCT01613755 | PHASE4 | COMPLETED | 18 | The Effect of Dipyridamole on the Pharmacokinetics of Metformin |
| NCT00153062 | PHASE4 | COMPLETED | 20332 | PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes: A Double-b... |
| NCT00161070 | PHASE4 | COMPLETED | 4500 | ESPRIT: European/Australasian Stroke Prevention in Reversible Ischaemia Trial |
| NCT00627783 | NA | TERMINATED | 642 | Randomized Strategy Trial Comparing Detection of Silent Ischemia With no Detecti... |
| NCT01295567 | PHASE4 | COMPLETED | 95 | Can Dipyridamole Induce Protection Against Ischemia and Reperfusion Injury in Pa... |
| NCT02468102 | N/A | COMPLETED | 99999 | A Pharmacoepidemiological Study of Rivaroxaban Use and Potential Adverse Outcome... |
| NCT07137104 | PHASE1, PHASE2 | NOT_YET_RECRUITING | 39 | A Phase I/IIa Study to Investigate the Safety, Tolerability, and Preliminary Eff... |
| NCT01947998 | N/A | COMPLETED | 50299 | A Pharmacoepidemiological Study of Rivaroxaban Use and Potential Adverse Outcome... |
| NCT00238667 | PHASE3 | COMPLETED | 250 | Cervical Artery Dissection in Stroke Study |
| NCT00562289 | PHASE3 | COMPLETED | 664 | Closure of Patent Foramen Ovale or Anticoagulants Versus Antiplatelet Therapy to... |
| NCT01661322 | PHASE3 | TERMINATED | 3096 | Safety and Efficacy of Intensive Versus Guideline Antiplatelet Therapy in High R... |
| NCT06899399 | NA | RECRUITING | 982 | Efficacy and Safety Study of Endovascular Treatment of Asymptomatic Carotid Arte... |
| NCT05081115 | N/A | RECRUITING | 10000 | The International Stress Echo Study to to Define the Future of Imaging |
| NCT01947985 | N/A | COMPLETED | 208958 | A Pharmacoepidemiological Study of Rivaroxaban Use and Potential Adverse Outcome... |
| NCT02565693 | PHASE2 | COMPLETED | 101 | Apixaban Versus Antiplatelet Drugs or no Antithrombotic Drugs After Anticoagulat... |
| NCT06549582 | NA | NOT_YET_RECRUITING | 160 | Effect of Taohong Tongluo Xiaoban Prescription on Reprogramming of Lipid Metabol... |
| NCT02630862 | NA | COMPLETED | 240 | Oxidative Stress and Oxysterols Profiling in Patients With Carotid Revasculariza... |
| NCT04666454 | PHASE4 | RECRUITING | 1000 | BROKEN-SWEDEHEART- Optimized Pharmacological Treatment for Broken Heart (Takotsu... |
| NCT00311402 | PHASE3 | COMPLETED | 1295 | JASAP: Japanese Aggrenox Stroke Prevention vs. Aspirin Programme, Phase III Stud... |
| NCT01947959 | N/A | COMPLETED | 665533 | A Pharmacoepidemiological Study of Rivaroxaban Use and Potential Adverse Outcome... |
| NCT05763862 | NA | RECRUITING | 350 | Genotype Guided Antiplatelet Therapy in Ischemic Stroke |
| NCT00465270 | NA | COMPLETED | 980 | Randomized Evaluation of Recurrent Stroke Comparing PFO Closure to Established C... |
| NCT06053021 | NA | UNKNOWN | 1200 | Antiplatelet Therapy for Acute Ischemic Stroke Patients With Thrombocytopenia |
相關文獻（18 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 11786451 | 2002 | Article | BMJ (Clinical research ed.) | Collaborative meta-analysis of randomised trials of antiplatelet therapy for pre... |
| 27816341 | 2016 | Article | Presse medicale (Paris, France | Stroke prevention. |
| 4119751 | 1973 | Article | Lancet (London, England) | Glycerol and stroke. |
| 9064773 | 1997 | Article | Science (New York, N.Y.) | Aspirin and stroke. |
| 16102029 | 2005 | Article | Journal of thrombosis and haem | Preventable stroke and stroke prevention. |
| 18342579 | 2008 | Article | Vascular pharmacology | Dipyridamole, cerebrovascular disease, and the vasculature. |
| 20955428 | 2010 | Article | Annals of the New York Academy | Effect of dipyridamole during acute stroke: exploring antithrombosis and neuropr... |
| 26274799 | 2015 | Article | Journal of comparative effecti | Antiplatelet therapies for secondary stroke prevention: an update on clinical an... |
| 30649687 | 2019 | Article | CNS drugs | Combination Therapy with Dipyridamole and Clopidogrel for Secondary Stroke Preve... |
| 15569877 | 2005 | Article | Stroke | Dipyridamole for preventing recurrent ischemic stroke and other vascular events:... |
| 12765506 | 2003 | Article | The Medical journal of Austral | Antiplatelet drugs. |
| 9744826 | 1998 | Article | Neurology | Dipyridamole trials in stroke prevention. |
| 18356634 | 2008 | Article | American journal of therapeuti | Acute ischemic coronary artery disease and ischemic stroke: similarities and dif... |
| 17389280 | 2007 | Article | Circulation | Secondary prevention of stroke and transient ischemic attack: is more platelet i... |
| 10543686 | 1999 | Article | Lancet (London, England) | Treatment and secondary prevention of stroke: evidence, costs, and effects on in... |
| 12535415 | 2003 | Article | The Cochrane database of syste | Dipyridamole for preventing stroke and other vascular events in patients with va... |
| 382146 | 1979 | Article | Postgraduate medicine | Antiplatelet drugs in thromboembolism. |
| 17636684 | 2007 | Article | The Cochrane database of syste | Dipyridamole for preventing stroke and other vascular events in patients with va... |
3. thrombotic disease L2 99.94%
臨床試驗（2 項）
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT01528800 | PHASE2 | COMPLETED | 85 | Inhibit Progression of Coronary Artery Calcification With Vitamin K in HemoDialy... |
| NCT01661322 | PHASE3 | TERMINATED | 3096 | Safety and Efficacy of Intensive Versus Guideline Antiplatelet Therapy in High R... |
相關文獻（20 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 26719230 | 2016 | Article | Lancet (London, England) | Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin... |
| 36696191 | 2023 | Article | Journal of thrombosis and haem | Targeting thromboinflammation in antiphospholipid syndrome. |
| 2107174 | 1990 | Article | Hematology/oncology clinics of | Thrombotic thrombocytopenic purpura and related disorders. |
| 382146 | 1979 | Article | Postgraduate medicine | Antiplatelet drugs in thromboembolism. |
| 32574107 | 2020 | Article | Emerging microbes & infections | Kawasaki-like diseases and thrombotic coagulopathy in COVID-19: delayed over-act... |
| 559478 | 1977 | Article | Archives of internal medicine | Platelet-latelet-. |
| 33760800 | 2021 | Article | Journal of cardiovascular phar | Revisiting the Evidence for Dipyridamole in Reducing Restenosis: A Systematic Re... |
| 2182246 | 1990 | Article | Clinical cardiology | Aspirin and dipyridamole and their limitations in the therapy of coronary artery... |
| 18174451 | 2008 | Article | Arteriosclerosis, thrombosis, | Translational therapeutics of dipyridamole. |
| 15494585 | 2004 | Article | JAMA | Oral antiplatelet therapy in cerebrovascular disease, coronary artery disease, a... |
| 20484211 | 2010 | Article | American journal of health-sys | Effects of antiplatelet and anticoagulant medications on the vasoocclusive and t... |
| 15095934 | 2004 | Article | Journal of the American Pharma | Peripheral arterial disease: pathophysiology, risk factors, and role of antithro... |
| 786606 | 1976 | Article | Drugs | Antithrombotic drugs: part II. |
| 379914 | 1979 | Article | Progress in cardiovascular dis | The role of platelets in thrombotic and vascular disease. |
| 19160220 | 2009 | Article | The Cochrane database of syste | Interventions for haemolytic uraemic syndrome and thrombotic thrombocytopenic pu... |
| 8123958 | 1994 | Article | The Annals of pharmacotherapy | Heparin-induced thrombotic thrombocytopenia. |
| 37350766 | 2023 | Article | Journal of Crohn's & colitis | Gut Microbiome-Generated Phenylacetylglutamine from Dietary Protein is Associate... |
| 28707198 | 2017 | Article | Cancer metastasis reviews | Platelet-targeted pharmacologic treatments as anti-cancer therapy. |
| 15461876 | 2004 | Article | Health technology assessment ( | Clinical effectiveness and cost-effectiveness of clopidogrel and modified-releas... |
| 7025599 | 1981 | Article | American family physician | Antiplatelet therapy. |
4. sick sinus syndrome 2, autosomal dominant L5 99.89%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
5. transient ischemic attack (disease) L1 99.87%
臨床試驗（15 項）
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT06983795 | N/A | NOT_YET_RECRUITING | 1000 | Pioneering Advancements in Cardiocerebrovascular Interactions in the Asia pacFIC... |
| NCT00027170 | N/A | COMPLETED | 8781 | Technical Development of Cardiovascular Magnetic Resonance Imaging |
| NCT01528800 | PHASE2 | COMPLETED | 85 | Inhibit Progression of Coronary Artery Calcification With Vitamin K in HemoDialy... |
| NCT03993119 | N/A | COMPLETED | 500 | Non-Interventional, Cross-sectional Study to Describe NOACs Management in Elderl... |
| NCT00738894 | NA | COMPLETED | 664 | GORE® HELEX® Septal Occluder / GORE® CARDIOFORM Septal Occluder and Antiplatelet... |
| NCT00562588 | PHASE4 | COMPLETED | 551 | EARLY: Prospective, Randomised, National, Multi-centre, Open-label, Blinded Endp... |
| NCT01613755 | PHASE4 | COMPLETED | 18 | The Effect of Dipyridamole on the Pharmacokinetics of Metformin |
| NCT00161070 | PHASE4 | COMPLETED | 4500 | ESPRIT: European/Australasian Stroke Prevention in Reversible Ischaemia Trial |
| NCT02468102 | N/A | COMPLETED | 99999 | A Pharmacoepidemiological Study of Rivaroxaban Use and Potential Adverse Outcome... |
| NCT01661322 | PHASE3 | TERMINATED | 3096 | Safety and Efficacy of Intensive Versus Guideline Antiplatelet Therapy in High R... |
| NCT03688815 | N/A | COMPLETED | 50 | Relationship Between the L-arginine Pathway Metabolites and Dipyridamole Stress ... |
| NCT06549582 | NA | NOT_YET_RECRUITING | 160 | Effect of Taohong Tongluo Xiaoban Prescription on Reprogramming of Lipid Metabol... |
| NCT02630862 | NA | COMPLETED | 240 | Oxidative Stress and Oxysterols Profiling in Patients With Carotid Revasculariza... |
| NCT00311402 | PHASE3 | COMPLETED | 1295 | JASAP: Japanese Aggrenox Stroke Prevention vs. Aspirin Programme, Phase III Stud... |
| NCT05763862 | NA | RECRUITING | 350 | Genotype Guided Antiplatelet Therapy in Ischemic Stroke |
相關文獻（20 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 11786451 | 2002 | Article | BMJ (Clinical research ed.) | Collaborative meta-analysis of randomised trials of antiplatelet therapy for pre... |
| 35470408 | 2022 | Article | Acta neurologica Taiwanica | Antiplatelets and Anticoagulants in Ischemic Stroke,Transient Ischaemic Attack: ... |
| 26304937 | 2015 | Article | Journal of the American Heart | Long-Term Antiplatelet Mono- and Dual Therapies After Ischemic Stroke or Transie... |
| 17389280 | 2007 | Article | Circulation | Secondary prevention of stroke and transient ischemic attack: is more platelet i... |
| 24157563 | 2014 | Article | Frontiers of neurology and neu | Antithrombotic therapy in transient ischemic attack patients. |
| 26042726 | 2015 | Article | Platelets | Platelet function testing in transient ischaemic attack and ischaemic stroke: A ... |
| 22277143 | 2012 | Article | Journal of clinical hypertensi | Antiplatelet therapy for transient ischemic attack. |
| 15569877 | 2005 | Article | Stroke | Dipyridamole for preventing recurrent ischemic stroke and other vascular events:... |
| 12535415 | 2003 | Article | The Cochrane database of syste | Dipyridamole for preventing stroke and other vascular events in patients with va... |
| 34399713 | 2021 | Article | BMC neurology | Antiplatelet drugs for secondary prevention in patients with ischemic stroke or ... |
| 12765506 | 2003 | Article | The Medical journal of Austral | Antiplatelet drugs. |
| 18454579 | 2008 | Article | The Consultant pharmacist : th | Urgent need for secondary stroke prevention after transient ischemic attack. |
| 31177983 | 2019 | Article | Stroke | Antiplatelet Therapy After Noncardioembolic Stroke. |
| 22282894 | 2012 | Article | Stroke | Dual or mono antiplatelet therapy for patients with acute ischemic stroke or tra... |
| 17636684 | 2007 | Article | The Cochrane database of syste | Dipyridamole for preventing stroke and other vascular events in patients with va... |
| 18343263 | 2008 | Article | Clinical therapeutics | Antiplatelet profiles of the fixed-dose combination of extended-release dipyrida... |
| 17847044 | 2007 | Article | Clinical cardiology | Antiplatelet therapy in cerebrovascular disease: implications of Management of A... |
| 22145656 | 2011 | Article | Journal of the American Academ | Preventing recurrent cerebrovascular events in patients with stroke or transient... |
| 20170841 | 2010 | Article | The Lancet. Neurology | Antithrombotic drugs for patients with ischaemic stroke and transient ischaemic ... |
| 17877660 | 2007 | Article | International journal of clini | Prevention of secondary stroke and transient ischaemic attack with antiplatelet ... |
6. sarcoglycanopathy L5 99.82%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
7. Wildervanck syndrome L5 99.78%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
8. macrocephaly, dysmorphic facies, and psychomotor retardation L5 99.77%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
9. cavernous sinus thrombosis L5 99.72%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
10. lateral sinus thrombosis L3 99.72%
臨床試驗（1 項）
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT01528800 | PHASE2 | COMPLETED | 85 | Inhibit Progression of Coronary Artery Calcification With Vitamin K in HemoDialy... |
台灣上市狀態
| 許可證號 | 商品名 | 劑型 | 適應症 | 狀態 |
|---|---|---|---|---|
| 多項 | 百心康等 | 錠劑/膠囊 | 慢性狹心症、血小板凝集降低 | 部分有效 |
備註：Aggrenox（dipyridamole + aspirin 複方）國際上用於中風預防，台灣需確認是否有上市。
安全性
藥物交互作用
Dipyridamole 的主要交互作用與其腺苷再攝取抑制作用相關：
| 併用藥物 | 注意事項 |
|---|---|
| Adenosine | 增強腺苷作用，需調整劑量 |
| 抗凝血劑 | 增加出血風險 |
| 抗血小板藥物 | 出血風險加成 |
重要警語
- 不穩定型心絞痛或急性心肌梗塞期間應謹慎使用
- 低血壓風險
- 可能引起頭痛、頭暈
結論
整體評估：已有成熟適應症
Dipyridamole 的 TxGNN 預測雖然分數很高，但兩項主要預測都與現有適應症高度重疊：
- 變異型心絞痛：文獻證據矛盾，且部分研究顯示無效
- 中風預防：Dipyridamole + aspirin 複方已是確立的二級預防方案
建議
- 不需要進行新適應症研究，因為預測的適應症已是現有用途或其延伸
- 對於變異型心絞痛，現有證據不支持將 dipyridamole 作為首選治療
- 中風預防應優先考慮 Aggrenox 複方或其他已證實有效的抗血小板方案
證據等級總結
| 預測適應症 | TxGNN 分數 | 臨床試驗 | 文獻支持 | 機轉合理性 | 綜合評估 |
|---|---|---|---|---|---|
| Prinzmetal angina | 0.9999 | 診斷用途 | 有（但矛盾） | 中等 | 與原適應症重疊，效果存疑 |
| 中風 | 0.9995 | 豐富 | 豐富 | 高 | 已為適應症（複方） |
報告產生日期：2026-02-11 資料來源：TxGNN 預測、ClinicalTrials.gov、PubMed、台灣 FDA
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引用本報告
如需引用本報告，請使用以下格式：
APA 格式：
TwTxGNN. (2026). Dipyridamole老藥新用驗證報告. https://twtxgnn.yao.care/drugs/dipyridamole/
BibTeX 格式：
@misc{twtxgnn_dipyridamole,
title = {Dipyridamole老藥新用驗證報告},
author = {TwTxGNN Team},
year = {2026},
url = {https://twtxgnn.yao.care/drugs/dipyridamole/}
}
免責聲明
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
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