Dipyridamole Coffee

Finally, purines such as caffeine (including dietary caffeine in coffee, tea, colas, and chocolate) and synthetic derivatives, such as theophylline, can interfere with the vascular actions of dipyridamole, These agents act to inhibit the adenosine A2A receptor, which serves to further emphasize the role of adenosine in the pharmacologic actions of dipyridamole (41-43), It has also been shown that this effect on A2A receptors is restricted to the vessel wall the direct anti-aggregatory actions of dipyridamole are not blocked by purines and may, if anything, be enhanced by the indirect effect of purines to upregulate A2A receptors (44,45). 

Caffeine (in tea, coffee, cola, etc.) may interfere with dipyrida-mole-thallium-201 scintigraphy tests. Similarly, theophylline can also reduce some of the effects of dipyridamole. 

Caffeine 4 mg/kg intravenously (roughly equivalent to 2 to 3 cups of coffee), given before dipyridamole-thallium-201 myocardial scintigraphy, caused a false-negative test result in a patient. A further study in 8 healthy subjects confirmed that caffeine inhibits the haemodynamic response to an infusion of dipyridamole. Similarly, oral theophylline markedly reduced the diagnostic accuracy of myocardial imaging using dipyridamole. In addition, intravenous aminophylline accelerated the myocardial washout rate of thallium-201 after a dipyridamole infusion. ... 

Patients should therefore abstain from caffeine (tea, coffee, chocolate, cocoa, cola, caffeine-containing analgesics etc.) - and other xanthine derivatives such as theophylline for 24 hours before dipyridamole testing, and if during the test the haemodynamic response is low (e.g. no increase in heart rate) the presence of caffeine should be suspected. ... 

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See also in sourсe #XX -- [ ]

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