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Home > Medications (Drugs) > Pentoxifylline > More information about Pentoxifylline

More information about Pentoxifylline

Pronunciation

(pen toks I fi leen)


U.S. Brand Names

Pentoxil®; Trental®

Synonyms

Oxpentifylline

Generic Available

Yes

Canadian Brand Names

Albert® Pentoxifylline; Apo-Pentoxifylline SR®; Nu-Pentoxifylline SR; ratio-Pentoxifylline; Trental®

Use

Treatment 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/Investigational

AIDS 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 Factor

C

Pregnancy Implications

Teratogenic effects were not observed in animal studies. There are no adequate and well-controlled studies in pregnant women.

Lactation

Enters breast milk/not recommended

Contraindications

Hypersensitivity to pentoxifylline, xanthines, or any component of the formulation; recent cerebral and/or retinal hemorrhage

Warnings/Precautions

Use with caution in patients with renal impairment

Adverse Reactions

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/Toxicology

Symptoms of overdose include hypotension, flushing, convulsions, deep sleep, agitation, bradycardia, and AV block. Treatment is supportive.

Drug Interactions

Inhibits 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 Interactions

Food: Food may decrease rate but not extent of absorption. Pentoxifylline peak serum levels may be decreased if taken with food.

Mechanism of Action

Mechanism of action remains unclear; is thought to reduce blood viscosity and improve blood flow by altering the rheology of red blood cells

Pharmacodynamics/Kinetics

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

Dosage

Adults: Oral: 400 mg 3 times/day with meals; may reduce to 400 mg twice daily if GI or CNS side effects occur

Administration

Tablets should be swallowed whole; do not chew, break, or crush.

Test Interactions

Decreased calcium (S), magnesium (S); false-positive theophylline levels

Dietary Considerations

May be taken with meals or food.

Patient Education

Inform 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 Considerations

Pentoxifylline 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 Considerations

Pentoxifylline 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 Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

May cause anxiety, confusion, depression, dizziness, or rarely agitation

Mental Health: Effects on Psychiatric Treatment

May cause seizures; use with caution with concomitant use of clozapine, which is associated with dose-dependent risk of seizures

Oncology: Emetic Potential

Very low (<10%)

Dosage Forms

Tablet, controlled release (Trental®): 400 mg

Tablet, extended release (Pentoxil®): 400 mg

References

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 Names

Agapurin® (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)

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