Pentoxifylline

A to Z Drug Facts

 Action Improves blood flow by decreasing blood viscosity.

 Indications Intermittent claudication on basis of chronic occlusive arterial disease of limbs. Unlabeled use(s): Treatment of psychopathological symptoms in patients with cerebrovascular insufficiency; treatment of diabetic angiopathies; reduction of incidence of stroke in patients with recurrent TIAs.

 Contraindications Intolerance to methylxanthines (ie, caffeine, theophylline); recent cerebral or retinal hemorrhage.

 Route/Dosage

ADULTS: PO 400 mg tid with meals for ³ 8 wk. If GI and CNS side effects occur, decrease to 400 mg bid. If side effects persist, discontinue.

 Interactions

Antihypertensives: Small decreases in blood pressure possible with patients receiving pentoxifylline while using antihypertensive drugs. Monitor blood pressure. If indicated, reduce dosage of the antihypertensive. Cimetidine: Effects of pentoxifylline may be increased. Theophylline: Concomitant administration with pentoxifylline leads to increased theophylline levels and possible toxicity in some patients. Monitor and adjust closely. Warfarin: Bleeding and prolonged prothrombin time possible in patients.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Angina; edema; hypotension; dyspnea; arrhythmia; tachycardia. CNS: Dizziness; insomnia; headache; tremor; anxiety; confusion. DERM: Brittle fingernails; pruritus; rash; flushing; urticaria. EENT: Blurred vision; conjunctivitis; nose-bleed; bad taste; excessive salivation; sore throat. GI: Dyspepsia; nausea; vomiting; belching; flatus; bloating; dry mouth. HEPA: Hepatitis; jaundice. HEMA: Leukopenia; pancytopenia; purpura; thrombocytopenia; decreased serum fibrinogen. RESP: Flu-like symptoms; laryngitis.

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Safety and efficacy for children < 18 yr not established. Renal impairment: Drug may accumulate, producing toxicity; lower dose may be necessary. Hemorrhage: Periodically examine patients with risk of hemorrhage for bleeding.

 Administration/Storage

• Give medication with meals.
• Reduced dosage may be needed if adverse GI or CNS effects develop.
• Store at room temperature in a tightly closed, light-resistant container.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Carefully assess for risk of hemorrhage (ie, recent surgery or peptic ulcer), and monitor PT/PTT and Hgb/Hct for indications of bleeding.
• Assess baseline BUN and creatinine, and monitor throughout therapy.
• Monitor patients taking pentoxifylline and anticoagulants for bleeding or changes in PT.

 Patient/Family Education

• Explain that improvement in symptoms may take 2 to 4 wk to notice and up to 8 wk for maximum relief.
• Explain importance of follow-up lab work for patients with high risk of bleeding or taking anticoagulant.
• In patients with occlusive peripheral vasospastic disorders, emphasize use of self-help measures to augment drug therapy (eg, exercise, weight control, no smoking).
• Review specifics of good foot care, including bathing of feet daily in lukewarm water and drying thoroughly, applying lanolin to feet after bathing, use of lambs wool between toes and feet, avoidance of extremes in temperature, wearing of clean cotton socks daily.
• Instruct patient to report the following symptoms to physician: Dizziness, chest pain, fainting, excessive bruising, abnormal bleeding.
• Advise patient that drug may cause dizziness, and to use caution while driving or performing other tasks requiring mental alertness.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts