Dosing and uses of Trental, Pentoxil (pentoxifylline)
Adult dosage forms and 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
Pediatric dosage forms and strengths
Safety and efficacy not established
Trental, Pentoxil (pentoxifylline) adverse (side) 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 and 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 of Trental, Pentoxil (pentoxifylline)
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%)
