Pentoxifylline
Pentoxifylline (Trental)
Pentoxifylline
(pen-tox- EYE-fih-leen)
Pregnancy Category: C Albert Pentoxifylline Apo-Pentoxifylline SR Trental (Rx)

Classification: Agent affecting blood viscosity

Action/Kinetics: Drug and active metabolites decrease the viscosity of blood and improve erythrocyte flexibility. Results in increased blood flow to the microcirculation and an increase in tissue oxygen levels. Mechanism may include (1) decreased synthesis of thromboxane A ₂, thus decreasing platelet aggregation, (2) increased blood fibrinolytic activity (decreasing fibrinogen levels), and (3) decreased RBC aggregation and local hyperviscosity by increasing cellular ATP. Peak plasma levels: 2-4 hr. Significant first-pass effect. t 1/2: pentoxifylline, 0.4-0.8 hr; metabolites, 1-1.6 hr. Excreted in the urine.

Uses: Intermittent claudication; not intended to replace surgery. Night cramps symptomatic of peripheral vascular disease. Investigational: To improve circulation in clients with cerebrovascular insufficiency, TIAs, sickle cell thalassemia, diabetic angiopathies and neuropathies, high-altitude sickness, strokes, acute and chronic hearing disorders, circulation disorders of the eye, severe recurrent aphthous stomatitis, leg ulcers, asthenozoospermia, and Raynaud's phenomenon.

Contraindications: Intolerance to pentoxifylline, caffeine, theophylline, or theobromine. Recent cerebral or retinal hemorrhage.

Special Concerns: Use with caution in impaired renal function and during lactation. Safety and efficacy in children less than 18 years of age not established. Geriatric clients may be at greater risk for manifesting side effects.

Side Effects: CV: Angina, chest pain, hypotension, edema. GI: Abdominal pain, flatus/bloating, dyspepsia, salivation, bad taste in mouth, N&V;, anorexia, constipation, dry mouth and thirst, cholecystitis. CNS: Dizziness, headache, tremor, malaise, anxiety, confusion, depression, seizures. Ophthalmologic: Blurred vision, conjunctivitis, scotomata. Dermatologic: Pruritus, rash, urticaria, brittle fingernails, angioedema. Respiratory: Dyspnea, laryngitis, nasal congestion, epistaxis. Miscellaneous: Flu-like symptoms, leukopenia, sore throat, swollen neck glands, change in weight, earache, malaise.

Overdose Management: Symptoms: Agitation, fever, flushing, hypotension, nervousness, seizures somnolence, tremors, loss of consciousness. Treatment: Gastric lavage followed by activated charcoal. Monitor BP and ECG. Support respiration, control seizures, and treat arrhythmias.

Drug Interactions: Antihypertensives / Small in BP; may need to antihypertensive dose Theophylline / Theophylline levels risk of toxicitiy Warfarin / Prolonged PT

How Supplied: Tablet, Extended Release: 400 mg

Dosage
?Extended-Release Tablets Intermittent claudication.
Adults: 400 mg t.i.d. with meals for at least 8 weeks. If side effects occur, reduce dose to 400 mg b.i.d.
Severe idiopathic recurrent aphthous stomatitis.
400 mg t.i.d. for 1 month.