Pentoxifylline

When ATH:
C04AD03

Characteristic

Production of purine. The white crystalline powder, water-soluble.

Pharmacological action.
Antiagregatine, improves microcirculation, angioprotektivnoe, vasodilator.

Application.

Violation of peripheral blood circulation (incl. occlusive disease, diabetic angiopathy, Raynaud's disease); atherosclerotic angiopathy, and circulatory, angionejropatija; trophic tissue disorders (incl. phlebeurysm, leg sores, gangrene, chilblain, post-thrombotic syndrome); cerebrovascular accident (the effects of cerebral arteriosclerosis, such as reduced concentration, dizziness, memory impairment), ischemic and post stroke status; poor circulation in the retina and choroid; otosclerosis, degenerative changes in the background of vascular pathology of the inner ear and hearing loss.

Contraindications.

Hypersensitivity, incl. other methylxanthine derivatives (caffeine, theophylline, theobromine), hemorrhagic stroke, massive bleeding, extensive retinal hemorrhage, acute myocardial infarction, pregnancy, lactation.

For i / v administration (additionally): arrhythmia, expressed atherosclerosis of the coronary or cerebral arteries, uncontrolled hypotension.

Restrictions apply.

BP lability (a tendency to hypotension), congestive heart failure, gastric ulcer and duodenal ulcer, impairment of renal function (clearance <30 ml / min), severe liver dysfunction, recently undergone surgery, increased tendency to bleeding, Age to 18 years (Safety and efficacy have not been determined).

Pregnancy and breast-feeding.

Contraindicated in pregnancy.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

At the time of treatment should stop breastfeeding (It passes into breast milk).

Side effects.

From the nervous system and sensory organs: headache, dizziness, anxiety, sleep disturbance, convulsions, visual disturbances, scotoma; very rarely-aseptic meningitis.

Cardio-vascular system and blood (hematopoiesis, hemostasis): tachycardia, kardialgija, arrhythmia, progression of angina, low blood pressure, leukopenia, pancytopenia, thrombocytopenia, fibrinopenia.

From the digestive tract: dry mouth, decreased appetite, bowel atony, aggravation cholecystitis, cholestatic hepatitis, increase in liver enzymes (IS, GOLD, Alkaline phosphatase, LDH).

For the skin and subcutaneous fat: facial flushing, flushing and upper chest, swelling, increased brittleness of nails.

Allergic reactions: itch, facial flushing, hives, angioedema, anaphylactic shock.

Pill further: a feeling of pressure and fullness in the stomach, nausea, vomiting, diarrhea.

Cooperation.

Pentoxifylline is able to enhance the effect of funds, lowering blood pressure (ACE inhibitors, nitrates). It may increase the effects of drugs, influencing blood clotting (indirect and direct anticoagulants, thrombolytics), antibiotics (incl. cephalosporins). Cimetidine increases the concentration in plasma pentoxifylline (the risk of side effects). Co-administration with other xanthines may cause excessive nervous excitement. Glucose-lowering effect of insulin or oral antidiabetic agents may be enhanced when taking pentoxifylline (an increased risk of hypoglycaemia, strict control of the state of such patients). In some patients, the simultaneous reception of pentoxifylline and theophylline may result in increased levels of theophylline in the blood and increased side effects of theophylline.

Overdose.

Symptoms: weakness, dizziness, decrease in blood pressure, feeling the tides, drowsiness or agitation, disturbance of consciousness, convulsions.

Treatment: gastric lavage, appointment of activated carbon, anticonvulsants, maintaining vital functions.

Dosing and Administration.

Inside, the initial dose: 600 mg/day 2-3 reception; With the improvement of switching to maintenance doses: by 100 mg 3 once a day; Course of treatment is 2-3 weeks or more.

B /, B / A, / m. The dosage and treatment regimen set individually.

Precautions.

Treatment should be under the control of blood pressure.

In patients with diabetes, taking hypoglycemic agents, the appointment of large doses can cause pronounced hypoglycemia (Dosage adjustment).

When assigning simultaneously with anticoagulants should be carefully monitored for indicators of blood coagulation system.

Patients, recently underwent surgery, requires systematic monitoring of the level of hemoglobin and hematocrit.

The dose administered must be reduced in patients with low and unstable blood pressure.

Older people may require a dose reduction (increased bioavailability and reduced clearance rate).

Smoking may reduce the therapeutic efficacy of the drug.

Compatible solution with pentoxifylline infusion solution should be checked in each case. During the I / infusion the patient should be supine.

Cooperation

Active substance	Description of interaction
Aminofillin	FKV. FMR. Increases (mutually) plasma levels and the probability of toxic manifestations.
Amlodipine	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Atenolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Acetylsalicylic acid	FMR: synergism. Against the background of pentoxifylline increases the risk of hemorrhagic complications.
Betaksolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Bisoprolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment requires monitoring of blood pressure.
Valsartan	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined periodic appointment is recommended to monitor blood pressure.
Warfarin	FMR: synergism. Against the background of enhanced effect of pentoxifylline; with a joint appointment is recommended constant monitoring of the prothrombin time.
Verapamil	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Gidroxlorotiazid	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Dalteparin sodium	FMR: synergism. Against the background of pentoxifylline enhanced effect and increases the risk of bleeding.
Diclofenac	FMR: synergism. Against the background of pentoxifylline increases the risk of hemorrhagic complications.
Diclofenac potassium	FMR: synergism. Against the background of pentoxifylline increases the risk of hemorrhagic complications.
Diltiazem	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment requires monitoring of blood pressure.
Dipiridamol	FMR: synergism. Strengthens (mutually) antiplatelet effect, It increases the risk of bleeding complications.
Doksazozin	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Ibuprofen	FMR: synergism. Against the background of pentoxifylline increases the risk of hemorrhagic complications.
Indapamid	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is necessary to control blood pressure.
Indomethacin	FMR: synergism. Against the background of pentoxifylline enhanced reduction of platelet aggregation, lengthened prothrombin time and increases the risk of bleeding.
Irbesartan	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Candesartan cïleksetïl	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined periodic appointment is recommended to monitor blood pressure.
Captopril	FMR: synergism. Strengthens (mutually) hypotensive effect; joint application requires monitoring of blood pressure.
Ketoprofen	FMR: synergism. Against the background of enhanced anticoagulant effect of pentoxifylline and an increased risk of bleeding complications.
Ketorolac	FMR: synergism. Against the background of enhanced anticoagulant effect of pentoxifylline and an increased risk of bleeding complications.
Klonidin	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined periodic appointment is recommended to monitor blood pressure.
Clopidogrel	FMR: synergism. Strengthens (mutually) antiplatelet effect, It increases the risk of bleeding complications.
Lisinopril	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Lozartan	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined periodic appointment is recommended to monitor blood pressure.
Meloxicam	FMR: synergism. Against the background of enhanced anticoagulant effect of pentoxifylline and an increased risk of bleeding complications.
Methyldopa	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Metoprolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Minoksidil	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Moexipril	FMR: synergism. Strengthens (mutually) hypotensive effect; joint application requires monitoring of blood pressure.
Nadolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Naproxen	FMR: synergism. Against the background of enhanced anticoagulant effect of pentoxifylline and an increased risk of bleeding complications.
Nitroglycerin	FMR: synergism. Strengthens (mutually) hypotensive effect; joint application requires monitoring of blood pressure.
Nifedipine	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment requires monitoring of blood pressure.
Perindopril	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Pindolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment requires monitoring of blood pressure.
Piroxicam	FMR: synergism. Against the background of enhanced anticoagulant effect of pentoxifylline and an increased risk of bleeding complications.
Prazosin	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined periodic appointment is recommended to monitor blood pressure.
Propranolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Ramipril	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Sotalol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Spirapril	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Telmisartan	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Theophylline	FMR. Strengthens (mutually) effect, It increases the risk and severity of adverse events.
Terazosin	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment of blood pressure should be monitored.
Ticlopidine	FMR: synergism. Strengthens (mutually) effect, It increases the risk of bleeding.
Timolol	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment requires monitoring of blood pressure.
Trandolapril	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Felodipine	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Phenylbutazone	FMR: synergism. Against the background of pentoxifylline enhanced reduction of platelet aggregation, lengthened prothrombin time and increases the risk of bleeding.
Flurbyprofen	FMR: synergism. Against the background of enhanced anticoagulant effect of pentoxifylline and an increased risk of bleeding complications.
Fosinopril	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is necessary to control blood pressure.
Furosemid	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Xlortalidon	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Celecoxib	FMR: synergism. Against the background of pentoxifylline enhanced reduction of platelet aggregation, lengthened prothrombin time and increases the risk of bleeding.
Enalapril	FMR: synergism. Strengthens (mutually) hypotensive effect; joint application requires monitoring of blood pressure.
Enalaprilat	FMR: synergism. Strengthens (mutually) hypotensive effect; the combined appointment is recommended to monitor blood pressure.
Enoxaparin sodium	FMR: synergism. Against the background of pentoxifylline enhanced effect and increases the risk of bleeding.
Eptifiʙatid	FMR: synergism. Strengthens (mutually) effect, It increases the risk of bleeding.
Esmolol	FMR: synergism. Strengthens (mutually) hypotensive effect; joint application requires monitoring of blood pressure.