pentoxifylline

pentoxifylline /pen·tox·i·fyl·line/ (pen″tok-sif´ah-lin) a xanthine derivative that reduces blood viscosity; used for the symptomatic relief of intermittent claudication.

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pen·tox·if·yl·line (pntk-sf-ln, -ln, pn-tks-fln, -n)

n.

A bitter-tasting compound that decreases blood viscosity and improves blood flow, used in the treatment of intermittent claudication.

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pentoxifylline

[pentok′sēfil′ēn]

a drug that lowers blood viscosity by making red blood cells even more flexible.

indications It is prescribed for the treatment of intermittent claudication associated with chronic occlusive arterial limb disease but should not be used as a replacement for other types of medications used for peripheral vascular disease because its efficacy is marginal. There are several unlabeled uses for the drug for which decreased blood viscosity could be advantageous, including cerebrovascular disease and diabetic neuropathy.

contraindications It should not be administered to patients who are allergic to xanthines or who have had recent episodes of bleeding, especially in the brain or retina, and should be used with caution if renal impairment is present.

adverse effects Among the most serious adverse effects are nausea, dyspepsia, dizziness, angina, arrhythmia, and hypotension.

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pentoxifylline (pen´toksif´lēn´),

n brand name: Trental;
drug class: hemorrheologic agent;
action: decreased blood viscosity, stimulates prostacyclin formation, increases blood flow by increasing flexibility of red blood cells (RBCs), decreased RBC hyperaggregation, reduces platelet aggregation, decreases fibrinogen concentration;
uses: intermittent claudication related to chronic occlusive vascular disease.

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pentoxifylline

a methylxanthine derivative that causes an increase in microvascular blood flow and has an immunomodulating effect by suppression of proinflammatory cytokines. Used in the treatment of some canine skin diseases, especially vasculitis and dermatomyositis.

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pentoxifylline

Apo-Pentoxyphylline (CA), Neotren (UK), Nu-Pentoxyphylline SR (CA), Pentoxil, Trental

Pharmacologic class: Hemorrheologic, xanthine derivative

Therapeutic class: Hematologic agent

Pregnancy risk category C

Action

Unknown. Thought to enhance blood flow to the circulatory system by increasing vasoconstriction and oxygen concentrations.

Availability

Tablets (controlled-release, extended-release): 400 mg

⊘Indications and dosages

➣ Intermittent claudication

Adults: 400 mg t.i.d. If adverse reactions occur, decrease to 400 mg b.i.d.

Dosage adjustment

• Renal impairment

Off-label uses

• Diabetic angiopathies and neuropathies
• Transient ischemic attacks
• Severe idiopathic recurrent aphthous stomatitis
• Raynaud's phenomenon

Contraindications

• Hypersensitivity to drug or methylxanthines (such as caffeine, theophylline, theobromine)
• Recent cerebral or retinal hemorrhage

Precautions

Use cautiously in:
• patients at risk for bleeding
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• Give with meals to minimize GI distress.
• Make sure patient swallows tablets whole without crushing, breaking, or chewing.

Route	Onset	Peak	Duration
P.O.	Variable	2-4 hr	8 hr

Adverse reactions

CNS: agitation, dizziness, drowsiness, headache, insomnia, nervousness, tremor, anxiety, confusion, malaise

CV: angina, edema, hypotension, arrhythmias

EENT: blurred vision, epistaxis, laryngitis, nasal congestion, sore throat

GI: nausea, vomiting, constipation, diarrhea, abdominal discomfort, belching, bloating, dyspepsia, flatus, cholecystitis, dry mouth, excessive salivation, anorexia

Hematologic: leukopenia

Respiratory: dyspnea

Skin: rash, urticaria, pruritus, brittle fingernails, flushing, angioedema

Other: bad taste, weight changes, thirst, flulike symptoms, lymphadenopathy

Interactions

Drug-drug. Anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs): increased risk of bleeding

Antihypertensives: additive hypotension

Theobromide, theophylline: increased risk of theophylline toxicity

Drug-herbs. Anise, arnica, asafetida, chamomile, clove, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, licorice: increased risk of bleeding

Drug-behaviors. Smoking: decreased pentoxifylline efficacy

Patient monitoring

• Monitor vital signs and cardiovascular status. Watch for arrhythmias, angina, edema, and hypotension.
• Frequently monitor prothrombin time and International Normalized Ratio in patients receiving warfarin concurrently.
• Assess theophylline level in patients receiving theophylline-containing drugs concurrently.

Patient teaching

• Instruct patient to take with meals and to swallow tablets whole without crushing, breaking, or chewing.
☞ Inform patient that drug can cause serious adverse effects. Instruct him to immediately report chest pain, swelling, and flulike symptoms.
• Tell patient smoking may make drug less effective and that many over-the-counter preparations (including aspirin, NSAIDs, and herbs) increase risk of bleeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

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pentoxifylline

Trental^® Vascular disease An agent used to prevent blood clots, especially in the elderly; it may also slow weight loss in CA ; may ↓ TNF Adverse effects Headache, tremor, dizziness, indigestion, N&V. See AIDS.