Trental (Pentoxifylline) 100 mg 60 tablets

Instructions for Trental

Composition Trental:

Active ingredients: pentoxifylline 100 mg.

Excipients:
lactose, starch, talc, colloidal silicon dioxide, magnesium stearate.
Shell composition:
methacrylic acid copolymer, sodium hydroxide, macrogol (polyethylene glycol) 8000, talc, titanium dioxide (E171). Trental

Pharmacodynamics Trental:

Microcirculation enhancing drug, angioprotector, xanthine derivative.
Trental improves the rheological properties of blood (fluidity) due to the effect on the pathologically altered deformability of red blood cells, inhibiting platelet aggregation and reducing high blood viscosity. Improves microcirculation in areas of impaired circulation.

The mechanism of action of pentoxifylline is associated with inhibition of phosphodiesterase and the accumulation of cAMP in the smooth muscle cells of blood vessels and blood cells. Trental

Having a weak myotropic vasodilating effect, pentoxifylline somewhat reduces OPSS and slightly dilates the coronary vessels.

Treatment with Trental improves the symptoms of cerebrovascular accidents.

The success of treatment with occlusive lesions of the peripheral arteries (for example, intermittent claudication) is manifested in lengthening the walking distance, eliminating night cramps in the calf muscles and the disappearance of pain at rest. Trental

Pharmacokinetics Trental:

Suction
After oral administration, pentoxifylline is almost completely absorbed from the digestive tract.
Bioavailability averages 19%.

Metabolism Trental
The main pharmacologically active metabolite 1- (5-hydroxyhexyl) -3,7-dimethylxanthine is determined in plasma at a concentration exceeding 2 times the concentration of unchanged substance, and is in a state of reversible biochemical equilibrium with it.

For this reason, pentoxifylline and its metabolite should be considered as an active whole, therefore, we can assume that the bioavailability of the active substance is significantly higher. Pentoxifylline is completely biotransformed in the body.

Breeding
T1 / 2 of pentoxifylline is 1.6 hours
Over 90% is excreted by the kidneys as unconjugated, water-soluble polar metabolites.
Pharmacokinetics in special clinical cases Trental

In patients with severe impaired renal function, the excretion of metabolites is slowed down.

In patients with impaired liver function, an extension of T1 / 2 of pentoxifylline and an increase in its bioavailability were noted.

Indications Trental:

• Disorders of peripheral circulation of atherosclerotic origin (for example, intermittent claudication);
• diabetic angiopathy;
• trophic disorders (e.g., leg ulcers, gangrene);
• cerebrovascular accident (consequences of cerebral atherosclerosis, such as impaired concentration, dizziness, memory impairment);
• ischemic and post-stroke conditions;
• circulatory disorders in the retina and choroid;
• otosclerosis;
• degenerative changes against the background of vascular pathology of the inner ear and hearing loss.

Contraindications Trental:

• Hypersensitivity to the components of the drug;
• massive bleeding;
• extensive retinal hemorrhage;
• cerebral hemorrhages;
• acute myocardial infarction;
• age up to 18 years;
• pregnancy and lactation (breastfeeding);
• hypersensitivity to other methylxanthines.

Caution should be used in patients with: severe cardiac arrhythmias (risk of worsening arrhythmias), arterial hypotension (risk of further decrease in blood pressure), chronic heart failure, with peptic ulcer of the stomach and duodenum, impaired renal function - CC less than 30 ml / min ( the risk of cumulation and an increased risk of side effects), with severe impaired liver function (risk of cumulation and an increased risk of side effects), an increased tendency to bleeding, including as a result of the use of anticoagulants or with violations of the blood coagulation system (risk of developing more severe bleeding), after recently undergoing surgical interventions.  Trental

Side effects Trental:

From the side of the central nervous system: headache, dizziness, anxiety, sleep disturbances, cramps; very rarely - aseptic meningitis.

Dermatological reactions: hyperemia of the skin of the face, flushing of the skin of the face and upper chest, swelling, increased fragility of the nails.

From the digestive system: xerostomia, anorexia, intestinal atony, a feeling of pressure and overflow in the stomach, nausea, vomiting, diarrhea; in some cases, intrahepatic cholestasis and increased activity of hepatic transaminases (AST, ALT), alkaline phosphatase (alkaline phosphatase).

From the cardiovascular system: tachycardia, arrhythmia, cardialgia, progression of angina pectoris, decreased blood pressure.
From the hematopoietic system: leukopenia, thrombocytopenia, pancytopenia, bleeding from blood vessels of the skin, mucous membranes, stomach, intestines, hypofibrinogenemia.
From the side of the organ of vision: visual impairment, scotoma.

Allergic reactions: itching, flushing of the skin, urticaria, angioedema, anaphylactic shock.

Side effects are possible with the use of Trental in high doses. Trental

Interaction Trental:

Pentoxifylline is able to enhance the effect of drugs that lower blood pressure (ACE inhibitors, nitrates).

Pentoxifylline can enhance the effect of drugs that affect the blood coagulation system (indirect and direct anticoagulants, thrombolytics), antibiotics (including cephalosporins).

Cimetidine increases the concentration of pentoxifylline in plasma (risk of side effects).
Joint administration with other xanthines can lead to excessive nervous excitement.

It is possible to increase the hypoglycemic effect of insulin or oral hypoglycemic agents when taking pentoxifylline (an increased risk of developing hypoglycemia). If necessary, combination therapy requires strict monitoring of patients.

In some patients, the simultaneous administration of pentoxifylline and theophylline can lead to an increase in theophylline concentration in blood plasma. This can lead to an increase or increase in the side effects associated with theophylline. Trental

How to take, course of administration and dosage Trental:

The dose Trental is set individually, in accordance with the characteristics of the patient.

The drug Trental is administered orally at 100 mg (1 tab.) 3 times / day, followed by a gradual increase in dose to 200 mg 2-3 times / day. The maximum single dose is 400 mg. The maximum daily dose is 1200 mg. The tablets should be swallowed whole during or immediately after a meal with a sufficient amount of water.

In patients with impaired renal function (CC less than 30 ml / min), the dose should be reduced to 1-2 tablets / day.

In patients with severely impaired liver function, a dose reduction is necessary taking into account the individual tolerance of the drug.

In patients with low blood pressure, as well as in people at risk due to a possible decrease in blood pressure (patients with severe coronary artery disease or with hemodynamically significant stenosis of the cerebral vessels), treatment can be started in small doses, in these cases the dose should be increased gradually.

Overdose Trental:

Symptoms: nausea, dizziness, tachycardia, decreased blood pressure, arrhythmia, flushing of the skin, chills, loss of consciousness, areflexia, tonic-clonic seizures.

Treatment: if necessary, carry out symptomatic therapy. The patient should be given a horizontal position with raised legs. The specific antidote is unknown. They monitor the vital functions of the body and general measures aimed at maintaining them, monitor the airway. With convulsions - diazepam.

Special instructions Trental:

Use for impaired liver function

In patients with severely impaired liver function, pentoxifylline T1 / 2 increases. Use with caution in patients with severely impaired liver function (risk of cumulation and increased risk of side effects).

Use for impaired renal function

In severe renal impairment, excretion of metabolites is slowed down. Use with caution in patients with impaired renal function - CC less than 30 ml / min (risk of cumulation and increased risk of side effects).

Special instructions Trental:

Treatment should be carried out under the control of blood pressure.
In patients with diabetes taking hypoglycemic agents, the administration of the drug in high doses can cause severe hypoglycemia (dose adjustment is required).

When prescribed simultaneously with anticoagulants, it is necessary to carefully monitor the indicators of the blood coagulation system.
In patients who have recently undergone surgery, a systematic monitoring of the level of hemoglobin and hematocrit is necessary.

In older people, a dose reduction (increased bioavailability and decreased excretion rate) may be required.
Smoking can reduce the therapeutic effectiveness of the drug Trental.
Pediatric Use
The safety and efficacy of pentoxifylline in children has not been sufficiently studied.