pentoxifylline (Rx)

Brand and Other Names:Trental, Pentoxil, more...Pentoxifylline SR
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet, extended release

  • 400mg

Intermittent Claudication

400 mg PO q8hr

Recommended duration of treatment: ≥8 weeks

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

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Interactions

Interaction Checker

and pentoxifylline

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              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 pharmacodynamic synergism. 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.

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                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

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                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

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                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.

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                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%)

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                pentoxifylline oral
                -
                400 mg tablet
                pentoxifylline oral
                -
                400 mg tablet
                pentoxifylline oral
                -
                400 mg tablet

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                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, usually 3 times daily or as directed by your doctor.Do not crush or chew this medication. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.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 persists or worsens.

                SIDE EFFECTS: Nausea, vomiting, gas, belching, and dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she 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 any of these rare but very serious side effects occur: fast/irregular heartbeat, easy bruising/bleeding.Seek immediate medical attention if this rare but very serious side effect occurs: chest pain.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention 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.Laboratory and/or medical tests (such as blood counts, blood pressure) should be performed from time to time to monitor your progress or check for side effects. 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 March 2021. Copyright(c) 2021 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.

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                Formulary

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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.