Dosing & Uses
Dosage Forms & Strengths
tablet, extended release
- 400mg
Intermittent Claudication
Indicated for intermittent claudication based on chronic occlusive arterial disease of the limbs
May improve function and symptoms but is not intended to replace more definitive therapy, such as surgical bypass, or removal of arterial obstructions when treating peripheral vascular disease
400 mg PO TID with meals
Effects may be seen within 2-4 weeks; recommended to continue treatment for at least 8 weeks
Note: American College of Chest Physicians (ACCP) discourages the use of pentoxifylline for the treatment of intermittent claudication refractory to exercise therapy (and smoking cessation) (Guyatt, 2012)
Dosage Modifications
Digestive or CNS side effects: Decrease dose to 400 mg BID; discontinue if adverse effects persist
Renal impairment (CrCl <30 mL/min): Decrease dose to 400 mg/day
Hepatic impairment: No information
Administration
Take with meals
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- fezolinetant
pentoxifylline will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors
Serious - Use Alternative (0)
Monitor Closely (19)
- amifostine
amifostine, pentoxifylline. Either increases effects of the other by anti-hypertensive channel blocking. Use Caution/Monitor.
- amiodarone
amiodarone will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- benazepril
pentoxifylline, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.
- captopril
pentoxifylline, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.
- cimetidine
cimetidine will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- ciprofloxacin
ciprofloxacin will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- duloxetine
duloxetine will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- fluoxetine
pentoxifylline increases toxicity of fluoxetine by anticoagulation. Use Caution/Monitor. May increase bleeding.
- fluvoxamine
fluvoxamine and pentoxifylline both increase anticoagulation. Use Caution/Monitor. may increase bleeding
- insulin degludec
pentoxifylline, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.
- insulin degludec/insulin aspart
pentoxifylline, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.
- insulin inhaled
pentoxifylline, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.
- methoxsalen
methoxsalen will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- mexiletine
mexiletine will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- nifedipine
pentoxifylline increases toxicity of nifedipine by Other (see comment). Use Caution/Monitor. Comment: May increase hypotensive effects.
- ofloxacin
ofloxacin will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- primaquine
primaquine will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- warfarin
pentoxifylline increases effects of warfarin by anticoagulation. Use Caution/Monitor.
- zileuton
zileuton will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
Minor (1)
- theophylline
pentoxifylline increases levels of theophylline by decreasing metabolism. Minor/Significance Unknown.
Adverse Effects
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
Warnings
Contraindications
Hypersensitivity to pentoxifylline or xanthine derivatives
Recent retinal or cerebral hemorrhage
Cautions
Use caution with risk factors for hemorrhage
Discontinue at first sign of anaphylaxis
Use with caution in renal impairment; exposure to pentoxifylline and/or active metabolites may increase; significance unknown
Use with caution in the elderly due to potential for renal impairment
Use with caution in hepatic impairment; exposure to pentoxifylline and/or active metabolites may increase; significance unknown
Pregnancy & Lactation
Pregnancy category: C
Lactation: Drug excreted in breast milk; discontinue therapy, or do not nurse
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Improves blood flow by decreasing blood viscosity and increasing red blood cell (RBC) flexibility
May increase tissues oxygenation through enhanced blood flow
Absorption
Bioavailability: 10-30%
Distribution
RBC binding: Parent drug, 45%; 5-hydroxyhexyl metabolite, 40%
Metabolism
Extensively metabolized in liver (first pass); also metabolized in erythrocytes
Metabolites: 5-hydroxyhexyl, 3-carboxypropyl
Elimination
Half-life: 24-48 min (Parent drug); 60-96 min (metabolites)
Excretion: Urine (50-80%, principally as metabolites), feces (<4%)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| pentoxifylline oral - | 400 mg tablet |  | |
| pentoxifylline oral - | 400 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
pentoxifylline oral
PENTOXIFYLLINE SUSTAINED-ACTION - ORAL
(PEN-tox-IF-i-lin)
COMMON BRAND NAME(S): Trental
USES: This medication is used to improve the symptoms of a certain blood flow problem in the legs/arms (intermittent claudication due to occlusive artery disease). Pentoxifylline can decrease the muscle aching/pain/cramps during exercise, including walking, that occur with intermittent claudication. Pentoxifylline belongs to a class of drugs known as hemorrheologic agents. It works by helping blood flow more easily through narrowed arteries. This increases the amount of oxygen that can be delivered by the blood when the muscles need more (such as during exercise) thereby increasing walking distance and duration.
HOW TO USE: Take this medication by mouth with food as directed by your doctor, usually 3 times daily.Swallow the tablets whole. Do not crush or chew the tablets. Doing so can release all of the drug at once, increasing the risk of side effects.Dosage is based on your medical condition and response to treatment.Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. Keep taking this medication even if you feel well. Do not stop this medication without consulting your doctor. Improvement in symptoms can occur in 2-4 weeks, but it may take up to 8 weeks to get the full benefit.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Nausea, vomiting, gas, belching, and dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fast/irregular heartbeat, easy bruising/bleeding.Get medical help right away if you have any very serious side effects, including: chest pain.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking pentoxifylline, tell your doctor or pharmacist if you are allergic to it; or to caffeine, or theophylline; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: recent stroke, recent bleeding in the eye, kidney problems, liver problems, recent major surgery, stomach ulcer.This drug may rarely make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/ketorolac/naproxen, "blood thinners" such as warfarin/dabigatran).Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: flushing, severe dizziness, seizures, drowsiness, loss of consciousness, fever, agitation.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood counts, blood pressure) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Lifestyle changes that may help reduce the symptoms of intermittent claudication include stopping smoking, exercising regularly, and losing weight. Ask your doctor about lifestyle changes that may benefit you.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised November 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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