Modified release dipyridamole is used in conjunction with aspirin (under the trade name Aggrenox®) in the secondary prevention of stroke and transient ischemic attack. Dipyridamole absorption is pH dependent and concomitant treatment with gastric acid suppressors will inhibit uptake significantly. The sustained formulation in Aggrenox® also corrects for this impairment.
 This practice is now confirmed by the ESPRIT trial.
It is not, however, licensed as monotherapy for stroke prophylaxis.
Use in nuclear stress testing
Dipyridamole (Persantine) is also used in pharmacological nuclear cardiac stress testing mediating coronary vasodilation.
Via the mechanisms mentioned above, when given as 3 to 5 min infusion it rapidly increases the local concentration of adenosine in the coronary circulation which causes vasodilation .
Vasodilation occurs in healthy arteries, whereas stenosed arteries remain narrowed. This creates a "steal" phenomenon where the coronary blood supply will increase to the dilated healthy vessels compared to the stenosed arteries which can then be detected by clinical symptoms of chest pain, electrocardiogram and echocardiography when it causes ischemia.
Flow heterogeneity (a necessary precursor to ischemia) can be detected with gamma cameras and SPECT using nuclear imaging agents such as Thallium-201 and Tc99m-Sestamibi. However relative differences in perfusion not necessarily imply absolute decrease in blood supply in the tissue supplied by a stenosed artery.
Other uses of dipyridamole
Dipyridamole also has non-medicinal uses in a laboratory context, such as the inhibition of cardiovirus growth in cell culture.