More information about Pentoxifylline
Pronunciation(pen toks I fi leen)
U.S. Brand NamesPentoxil®; Trental®
Canadian Brand NamesAlbert® Pentoxifylline; Apo-Pentoxifylline SR®; Nu-Pentoxifylline SR; ratio-Pentoxifylline; Trental®
UseTreatment of intermittent claudication on the basis of chronic occlusive arterial disease of the limbs; may improve function and symptoms, but not intended to replace more definitive therapy
Use - Unlabeled/InvestigationalAIDS patients with increased TNF, CVA, cerebrovascular diseases, diabetic atherosclerosis, diabetic neuropathy, gangrene, hemodialysis shunt thrombosis, vascular impotence, cerebral malaria, septic shock, sickle cell syndromes, and vasculitis
Pregnancy Risk FactorC
Pregnancy ImplicationsTeratogenic effects were not observed in animal studies. There are no adequate and well-controlled studies in pregnant women.
LactationEnters breast milk/not recommended
ContraindicationsHypersensitivity to pentoxifylline, xanthines, or any component of the formulation; recent cerebral and/or retinal hemorrhage
Warnings/PrecautionsUse with caution in patients with renal impairment
1% to 10%:
Central nervous system: Dizziness, headache
Gastrointestinal: Dyspepsia, nausea, vomiting
<1%; Anaphylactoid reaction, angioedema, anxiety, arrhythmia, aseptic meningitis, blurred vision, chest pain, cholecystitis, confusion, congestion, depression, dyspnea, edema, hallucinations, hepatitis, hypotension, jaundice, rash, seizure, tremor
Overdosage/ToxicologySymptoms of overdose include hypotension, flushing, convulsions, deep sleep, agitation, bradycardia, and AV block. Treatment is supportive.
Drug InteractionsInhibits CYP1A2 (weak)
Increased effect/toxic potential with cimetidine (increased levels) and other H2 antagonists, warfarin; increased effect of antihypertensives
Increased toxicity with theophylline
Ethanol/Nutrition/Herb InteractionsFood: Food may decrease rate but not extent of absorption. Pentoxifylline peak serum levels may be decreased if taken with food.
Mechanism of ActionMechanism of action remains unclear; is thought to reduce blood viscosity and improve blood flow by altering the rheology of red blood cells
Absorption: Well absorbed
Metabolism: Hepatic and via erythrocytes; extensive first-pass effect
Half-life elimination: Parent drug: 24-48 minutes; Metabolites: 60-96 minutes
Time to peak, serum: 2-4 hours
Excretion: Primarily urine
DosageAdults: Oral: 400 mg 3 times/day with meals; may reduce to 400 mg twice daily if GI or CNS side effects occur
AdministrationTablets should be swallowed whole; do not chew, break, or crush.
Test InteractionsDecreased calcium (S), magnesium (S); false-positive theophylline levels
Dietary ConsiderationsMay be taken with meals or food.
Patient EducationInform prescriber of all prescriptions, OTC medications, or herbal products you are taking, and any allergies you have. Do not take any new medication during therapy unless approved by prescriber. This may relieve pain of claudication, but additional therapy may be recommended. Take as prescribed for full length of prescription. May cause dizziness (use caution when driving or engaging in tasks that are potentially hazardous until response to drug is known); or heartburn, nausea, or vomiting (small, frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help). Report chest pain; swelling of lips, mouth, or tongue; persistent headache; respiratory difficulty; rash; or unrelieved nausea or vomiting. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.
Anesthesia and Critical Care Concerns/Other ConsiderationsPentoxifylline may be used in the treatment of peripheral vascular disease, however, its efficacy is not fully established. Therapeutic effects may be seen after 2-4 weeks.
Cardiovascular ConsiderationsPentoxifylline may be used in the treatment of peripheral vascular disease; however, its efficacy is not fully established. The role of cytokine modulation with pentoxifylline in patients with heart failure is under investigation.
Dental Health: Effects on Dental TreatmentNo significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic PrecautionsNo information available to require special precautions
Mental Health: Effects on Mental StatusMay cause anxiety, confusion, depression, dizziness, or rarely agitation
Mental Health: Effects on Psychiatric TreatmentMay cause seizures; use with caution with concomitant use of clozapine, which is associated with dose-dependent risk of seizures
Oncology: Emetic PotentialVery low (<10%)
Tablet, controlled release (Trental®): 400 mg
Tablet, extended release (Pentoxil®): 400 mg
Aronoff SC, Quinn FJ, Carpenter LS, et al, "Effects of Pentoxifylline on Sputum Neutrophil Elastase and Pulmonary Function in Patients With Cystic Fibrosis: Preliminary Observations,"J Pediatr, 1994, 125(6 Pt 1):992-7.
Berman W Jr, Berman N, Pathak D, et al, "Effects of Pentoxifylline (Trental®) on Blood Flow, Viscosity, and Oxygen Transport in Young Adults With Inoperable Cyanotic Congenital Heart Disease,"Pediatr Cardiol, 1994, 15(2):66-70.
Dolgin J, Abrams B, and Tucker J, "Survival With Massive Pentoxifylline Overdose and High Serum Levels,"Vet Hum Toxicol, 1994, 36:369.
Furukawa S, Matsubara T, Umezawa Y, et al, "Pentoxifylline and Intravenous Gamma Globulin Combination Therapy for Acute Kawasaki Disease,"Eur J Pediatr, 1994, 153(9):663-7.
Garnier R, Riboulet-Delmas G, Chatenet T, et al, "Acute Pentoxifylline in Children,"Ann Pediatr Paris, 1986, 33(1):62-3.
Lauterbach R, "Pentoxifylline Treatment of Persistent Pulmonary Hypertension of Newborn,"Eur J Pediatr, 1993, 152(5):460. (I.V. use)
Lauterbach R, Pawlik D, Tomaszczyk B, et al, "Pentoxifylline Treatment of Sepsis of Premature Infants; Preliminary Clinical Observations,"Eur J Pediatr, 1994, 153(9):672-4. (I.V. use)
MacDonald MJ, Shahidi NT, Allen DB, et al, "Pentoxifylline in the Treatment of Children With New-Onset Type I Diabetes Mellitus,"JAMA, 1994, 271(1):27-8.
Sznajder IJ, Bentur Y, and Taitelman U, "First and Second Degree Atrioventricular Block in Oxpentifylline Overdose,"Br Med J (Clin Res Ed), 1984, 288(6410):26.
Ward A and Clissold SP, "Pentoxifylline: A Review of Its Pharmacodynamic and Pharmacokinetic Properties and Its Therapeutic Efficacy,"Drugs, 1987, 34(1):50-97.
International Brand NamesAgapurin® (CZ, DE, PL, RO, RU, TH); Agapurin retard® (SG); Albert® Pentoxifylline (CA); Angiopent® (RO); Angiopurin® (HU); Apo-Pentoxifylline SR® (CA); Apo-Pentox® (PL); Arbiflex® (RU); Artal® (FI); Azupentat® (CZ, DE, PL, RU, TR); Chinotal® (HU, RU); Claudicat® (DE, PT); Damaton® (YU); Dartelin® (HR, PL, RO, SI); Dinostral® (CH); Dospan-Pento® (AR); durapental® (DE); Elastab® (TH); Elorgan® (ES); Erypent® (ID); Erytral® (ID); Fixoten® (MX); Flexital® (RU, TH); Genitum® (AR); Grofilina® (PL); Haemodyn® (AT); Hatial® (FR); Hemovas® (ES); Herden® (CY, JO); Kentadin® (MX); Lentrin® (ID); Medoxifilin® (YU); Mellinorm® (RU); Nu-Pentoxifylline SR (CA); Oxopurin® (IL); Oxyphil-400 Retard® (RO); Penlol® (TH); Pentamon® (HR); Pentilin® (CZ, HR, PL, RO, RU, SI); Pento AbZ® (DE); Pentoflux® (FR); Pentohexal® (AT, CZ, DE, PL, RO); Pentoksifilin® (YU); Pentoksilin® (YU); Pentomer® (AT, CZ, RU); Pento-Puren® (DE); Pentox® (BR, TR); Pentoxifilina Alter® (ES); Pentoxifilina Belmac® (ES); Pentoxifilina Davur® (ES); Pentoxifilina Farmabion® (ES); Pentoxifilina L.CH.® (CL); Pentoxifilina Merck® (CO); Pentoxifilin® (CO, RO, YU); Pentoxifyllin acis® (DE); Pentoxifyllin AL® (CZ, DE, HU); Pentoxifyllin Atid® (DE); Pentoxifyllin Basics® (DE); Pentoxifyllin® (BG); Pentoxifyllin-B® (HU); Pentoxifylline-Akri® (RU); Pentoxifylline-Teva® (IL); Pentoxifylline® (YU); Pentoxifyllin Lindo® (DE); Pentoxifyllin Pharmavit® (HU); Pentoxifyllin-ratiopharm® (DE, LU); Pentoxifyllin Sandoz® (DE); Pentoxifyllin Stada® (DE); Pentoxifyllinum® (CZ); Pentoxi Genericon® (AT); PentoxiMed® (AT); Pentoxi-Mepha® (CH); Pentoxin® (DO, FI); Pentox von ct® (DE, LU, RO); Pentoxyfillin® (YU); Pentoxy Heumann® (DE); Perental® (BR); Peridane® (MX); Perivax R® (EC); Pexal® (CR, EC, GT, HN, PA, SV); Platof® (ID); Polfilin® (PL); Previscan® (AR); Ralofekt® (DE); ratio-Pentoxifylline (CA); Rentylin® (DE, LU); Reotal® (ID); Retimax® (ES); Sufisal® (MX); Tarontal® (ID); Torental® (BE, FR, LU); Trenfyl® (ID); Trenlin SR® (SG); Trental® (AR, AT, AU, BD, BR, CA, CH, CL, CO, CR, CZ, DE, DK, DO, EC, FI, GB, GT, HK, HN, HR, HU, ID, IE, IL, IN, IT, MX, NL, NO, NZ, PA, PL, PT, RO, RU, SG, SI, SV, TH, TR, YU, ZA); Trentilin® (TR); Trentox® (ID); Trenxy® (ID); Vasofyl® (MX); Vasonit® (AT, RO, RU); Zumavastal® (ID)