Buy Trental Online

Pentoxifylline (pentoxifylline)

OTHER BRAND NAMES

Trental (Discontinued)

THERAPEUTIC CLASS

Blood viscosity reducer

DEA CLASS

RX

INDICATIONS

Treatment of intermittent claudication on the basis of chronic occlusive arterial disease of the limbs.

ADULT DOSAGE

Intermittent Claudication

400mg tid w/ meals for at least 8 weeks

DOSING CONSIDERATIONS

Renal Impairment
Severe (CrCl <30mL/min): Reduce dose to 400mg qd

Elderly
Start at lower end of dosing range

Adverse Reactions
Digestive and CNS Side Effects:
Reduce to 400mg bid; d/c if side effects persist at lower dose

ADMINISTRATION

Oral route

Take w/ meals

HOW SUPPLIED

Tab, Extended-Release: 400mg

CONTRAINDICATIONS

Recent cerebral and/or retinal hemorrhage, intolerance to methylxanthines (eg, caffeine, theophylline, theobromine).

WARNINGS/PRECAUTIONS

Not intended to replace more definitive therapy (eg, surgical bypass, removal of arterial obstructions) when treating peripheral vascular disease. D/C at the 1st sign of anaphylactic/anaphylactoid reaction. Angina, hypotension, and arrhythmia occasionally reported in patients w/ concurrent coronary artery and cerebrovascular diseases. Bleeding and/or prolonged PT reported; perform periodic exams for bleeding (eg, Hgb, Hct) in patients w/ risk factors complicated by hemorrhage (eg, recent surgery, peptic ulceration, cerebral/retinal bleeding). Increased exposure in patients w/ hepatic/renal impairment.

ADVERSE REACTIONS

Belching/flatus/bloating, dyspepsia, N/V, dizziness, headache, tremor, angina/chest pain.

DRUG INTERACTIONS

Bleeding and/or prolonged PT reported w/ anticoagulants or platelet aggregation inhibitors; frequently monitor PT if on warfarin. May increase theophylline levels; monitor for signs of toxicity and adjust theophylline dose as necessary. Strong CYP1A2 inhibitors (eg, ciprofloxacin, fluvoxamine) may increase exposure. Small decreases in BP observed w/ concomitant antihypertensive therapy; periodically monitor BP and reduce antihypertensive agent dose if indicated. Increased anticoagulant activity w/ vitamin K antagonists; monitor anticoagulant activity when pentoxifylline is introduced or the dose is changed.

PREGNANCY AND LACTATION

Category C, not for use in nursing.

MECHANISM OF ACTION

Blood viscosity reducer; precise mechanism of action has not been established. Increases blood flow to affected microcirculation and enhances tissue oxygenation. Produces dose-related hemorrheologic effects, lowers blood viscosity, improves erythrocyte flexibility, increases leukocyte deformability, and inhibits neutrophil adhesion and activation.

PHARMACOKINETICS

Absorption: Tmax=2-4 hrs. Distribution: Found in breast milk. Metabolism: 1st pass; Metabolite I (1-[5-hydroxyhexyl]-3,7-dimethylxanthine) and Metabolite V (1-[3-carboxypropyl]-3,7-dimethylxanthine) (major metabolites). Elimination: (Sol) Urine, feces (<4%); T1/2=0.4-0.8 hrs.

ASSESSMENT

Assess for risk factors for hemorrhage, intolerance to drug or methylxanthines, coronary artery/cerebrovascular diseases, hepatic/renal impairment, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for signs/symptoms of anaphylactic/anaphylactoid reaction, angina, arrhythmia, hypotension, digestive/CNS side effects, and other adverse reactions. Perform periodic exams for bleeding (eg, Hgb, Hct) w/ risk factors complicated by hemorrhage. Frequently monitor PT if on warfarin. Monitor renal function.

PATIENT COUNSELING

Inform of risks and benefits of therapy. Instruct to report to the physician if any adverse reactions develop. Instruct to notify physician if taking other drugs, or if pregnant or planning to become pregnant.

STORAGE

20-25°C (68-77°F). Protect from light.

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