Treatment of peripheral vascular diseaseevident as intermittent claudication, venous leg ulcers.
Pentoxifylline and its metabolites improve the flow properties of blood by decreasing its viscosity. In patients with chronic peripheral arterial disease, this increases blood flow to the affected microcirculation and enhances tissue oxygenation. The precise mode of action of pentoxifylline and the sequence of events leading to clinical improvement are still to be defined. Pentoxifylline administration has been shown to produce dose-related hemorrheologic effects, lowering blood viscosity, and improving erythrocyte flexibility. Leukocyte properties of hemorrheologic importance have been modified in animal and in vitro human studies. Pentoxifylline has been shown to increase leukocyte deformability and to inhibit neutrophil adhesion and activation. Tissue oxygen levels have been shown to be significantly increased by therapeutic doses of pentoxifylline in patients with peripheral arterial disease.
One tablet two to three times a day with meals for at least 8 weeks.
Precautions for use: The blood-sugar-lowering effect of insulin or oral antidiabetics may be potentiated. Therefore it is recommended that patients under medication for diabetes mellitus be carefully monitored. Post-marketing cases of increased anti-coagulant activity have been reported in patients concomitantly treated with pentoxifylline and anti-vitamin K. Monitoring of anti-coagulant activity in these patients is recommended when pentoxifylline is introduced or the dose is changed.
Take into account: The blood-pressure-lowering efect of antihypertensive agents and other drugs with blood-pressure-lowering potential may be increased by Pentoxifylline.
Concomitant administration of pentoxifylline and theophylline may increase theophylline levels in some patients. Therefore, there may be an increase in and intensifcation of adverse reactions from theophylline.
Concomitant administration with ciprofoxacin may increase the serum concentration of pentoxifylline in some patients. Therefore, there may be an increase in and intensifcation of adverse reactions associated with co-administration.
Potential additive efect with platelet aggregation inhibitors: Because of the increased risk of bleeding, the concomitant administration of a platelet aggregation inhibitor (such as clopidogrel, eptifibatide, tirofiban, epoprostenol, iloprost, abciximab, anagrelide, NSAIDs other than selective COX-2 inhibitors, acetylsalicylates [ASA/LAS], ticlopidine, dipyridamole) with pentoxifylline should be undertaken with caution.
Concomitant administration with cimetidine may increase the plasma concentration of pentoxifylline and the active Metabolite.
Recent cerebral and/or retinal hemorrhage or in patients who have previously exhibite intolerance to this product or methylxanthines such as caffeine, theophylline, & theobromine. Patients on warfarin should have frequent monitoring of prothrombin times, while patients with other risk factors complicated by hemorrhage (e.g., recent surgery, peptic ulceration, cerebral and/or retinal bleeding) should have periodic examinations for bleeding including, hematocrit and/or hemoglobin.
Dyspnea, edema, hypotension, anorexia, cholecystitis, constipation, dry mouth/thirst, anxiety, confusion, depression, seizures, epistaxis, flu-like symptoms, laryngitis, nasal congestion, brittle fingernails, pruritus, rash, urticaria, angioedema, blurred vision, conjunctivitis, earache, scotoma, bad taste, excessive salivation, leukopenia, malaise, sore throat/swollen neck glands, weight change.
Used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Because of the potential for tumorigenicity shown for Pentoxifylline in rats, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Initial symptoms of acute overdose with pentoxifylline may be nausea, dizziness, tachycardia or a fall in blood pressure. Furthermore, signs such as fever, agitation, flush, loss of consciousness, areflexia, tonic -clonic convulsions and as a sign of gastrointestinal bleeding - coffee-ground vomiting may occur. No specific antidote is known. If ingestion has only just taken place, attempts may be made to prevent further systemic absorption of the active ingredient by primary elimination of the toxin (e.g. gastric lavage) or by delaying its absorption (e.g. activated charcoal).
Keep in a cool and dry place, away from light. Do not use later than date of expiry. Keep all medicine out of the reach of children. To be dispensed only on the prescription of a registered physician.
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