Pentoxifylline

Indications

Pentoxifylline is used for: Peripheral vascular disease

Adult Dose

Oral Peripheral vascular disease Adult: As modified-release formulation: 400 mg tid (normally for at least 8 wk) May reduce to 400 mg bid if GI or CNS adverse effects occur. Intermittent Claudication 400 mg PO q8hr Recommended duration of treatment: >8 weeks Hepatic impairment: Dose reduction may be needed in severe impairment.

Child Dose

Safety and efficacy not established

Renal Dose

Renal impairment: Moderate impairment (CrCl about 60 ml/min): 400 mg bid; Severe impairment (CrCl about 20 ml/min): 400 mg once daily; may reduce further to 400 mg once every other day if needed.

Administration

Should be taken with food.

Contra Indications

Previous hypersensitivity reactions to xanthine-related products e.g. caffeine, theophylline and theobromine. Recent cerebral and/or retinal haemorrhage. Porphyria.

Precautions

Avoid use in patients with severe cardiac arrhythmias or acute MI. Caution when used in patients with ischaemic heart disease or hypotension. Impaired renal or hepatic function. Start at lower dose in elderly; safety and efficacy not established in children. Tablets should not be chewed, crushed or broken; swallow whole. Pregnancy, lactation. Lactation: Drug excreted in breast milk; discontinue therapy, or do not nurse

Pregnancy-Lactation

Pregnancy category: C Lactation: Drug excreted in breast milk; discontinue therapy, or do not nurse

Interactions

Concurrent use with ciprofloxacin may increase the adverse effect of pentoxifylline. Concurrent use may increase serum levels of theophylline derivatives. Potentially Fatal: May increase risk of adverse effect when used with ketorolac.

Adverse Effects

Side effects of Pentoxifylline : 1-10% Nausea, Vomiting <1% Angina, Anaphylaxis, Anorexia, Aplastic anemia, Pancytopenia, Conjunctivitis, Angioedema, Aseptic meningitis, Chest pain, Leukemia, Leukopenia, Cholecystitis, Hepatitis, Seizure, Scotoma, Thrombocytopenia, Increased live enzyme Potentially Fatal: Fatal haemorrhage (cerebral and GI tract); anaphylactoid reaction.

Mechanism of Action

Pentoxifylline reduces blood viscosity by increasing deformability of leukocytes and erythrocytes; and decreasing neutrophil adhesion/activation. It also improves microcirculation and peripheral tissue oxygenation through better blood flow. It has also been used in cerebrovascular disorders.