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

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

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%)

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)