pentoxifylline

pentoxifylline

 [pen″tok-sif´ah-lin]

a xanthine derivative that reduces blood viscosity; used for the symptomatic relief of intermittent claudication in peripheral vascular disease.

pentoxifylline

Apo-Pentoxiphylline, Neotren (UK), Pentoxil, Pentoxiphylline (CA), Pentoxiphylline SR (CA), 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.

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.

pentoxifylline

(pĕn′tŏk-sĭf′ə-lēn′, -lĭn, pĕn-tŏk′sə-fĭl′ēn′, -ĭn)

n.

A drug, C₁₃H₁₈N₄O₃, that decreases blood viscosity and improves blood flow, used to treat intermittent claudication.

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.