Pentoxifylline (
oxpentifylline) is an orally active haemorheological agent for the treatment of
peripheral vascular disease,
cerebrovascular disease and a number of other conditions involving a defective regional microcirculation.
Pentoxifylline acts primarily by increasing red blood cell deformability, by reducing blood viscosity and by decreasing the potential for platelet aggregation and
thrombus formation. Extensive open and placebo-controlled studies have shown that
pentoxifylline 600 to 1200 mg/day for at least 6 weeks is associated with subjective and objective improvements in 60 to 100% of patients with
peripheral vascular disease. The most commonly assessed clinical parameter, walking distance, is usually improved by about 100%, although much greater improvements have also been documented. Other parameters which have been clearly improved include lower limb rest
pain, paraesthesia, muscle blood flow,
cramps and
leg ulcers.
Pentoxifylline has produced consistently better results than placebo, and in those studies using comparative drugs, better results than
nylidrin,
adenosine and
naftidrofuryl. In patients with
cerebrovascular disorders, open studies with
pentoxifylline, usually at a dosage of 600 to 1200 mg/day (300 to 600 mg/day in Japan), have shown marked overall clinical improvements in about 85% of patients. Symptomatic improvements in rehabilitation psychometric tests, neuromotor and speech deficits and other subjective symptoms have accompanied increased cerebral blood flow, particularly to ischaemic areas.
Pentoxifylline would appear to be useful in most types of
cerebrovascular disease including transient ischaemic attacks, sequelae of
cerebral thrombosis and haemorrhage, and chronic ischaemic disorders. In patients with chronic
cerebrovascular disease pentoxifylline 600 to 1200 mg/day conferred significant clinical benefit compared with placebo and in isolated studies proved to be superior to drugs such as
co-dergocrine mesylate,
adenosine and
pyrithioxine. Preliminary studies indicate that
pentoxifylline may also prove useful in vaso-occlusive crises of
sickle cell disease, some
hearing disorders, disorders of eye circulation, high
altitude sickness and
asthenozoospermia.
Pentoxifylline is usually well tolerated when administered as the conventional
controlled release formulation, gastrointestinal symptoms (about 3%) being the most common complaint, although these and other adverse effects have not occurred to a significantly greater extent than with placebo. Thus,
pentoxifylline offers a well-tolerated and effective alternative to the treatment options available for patients with
peripheral vascular disease.(ABSTRACT TRUNCATED AT 400 WORDS)