Crunching punches. Circulatory disorders in the eye (acute and chronic circulatory disorders within the retina and the choroid of the eye). Internal ear dysfunction (eg hearing impairment, sudden loss of hearing) due to changes in circulation. The states of cerebral ischemia (states after stroke, abnormal brain function of vascular origin with symptoms such as: lack of concentration, dizziness, impaired memory).
Pentoxifylline facilitates blood flow through the capillaries, improving blood supply to tissues. It exhibits the following properties: increases erythrocyte elasticity, inhibits erythrocyte aggregation, inhibits platelet aggregation by enhancing prostacyclin synthesis, reduces pathologically increased fibrinogen concentration, inhibits leukocyte adhesion to the endothelium, reduces leukocyte activation and resulting endothelial damage, reduces blood viscosity. A slight vasodilatory and inotropically positive effects have also been described. Pentoxifylline is quickly and almost completely absorbed from the gastrointestinal tract, metabolizes the first pass in the liver, bioavailability is 20-30%. Cmax occurs about 2 hours after taking the drug. T0,5 pentoxifylline is about 1.6 h, and metabolites - 1-1.6 h. It is excreted mainly in the urine in the form of metabolites.
Contraindications:
Hypersensitivity to Pentoxifylline, other methylxanthine derivatives or other components of the preparation. A recent myocardial infarction or stroke. Bleeding with a significant severity and disease with a high risk of hemorrhage. Volleyball stroke.
Precautions:
After the first signs of anaphylactic or anaphylactoid reaction, pentoxifylline should be discontinued immediately and the physician should be informed. Caution should be used in patients with hypotension or severe coronary artery disease because transient hypotension may occur, which may occasionally result in decreased flow in the coronary vessels. Low-dose therapy should be initiated in patients with hypotension or in patients with unstable circulation, as well as in patients whose blood pressure reduction is associated with a particular risk (eg patients with severe coronary artery disease or significant narrowing of the blood vessels supplying the brain) - In such cases, the dose should be increased gradually. Patients with: renal dysfunction, severe hepatic impairment, severe arrhythmia, myocardial infarction, hypotension, with increased bleeding tendencies caused by (eg coagulation disorders) treated with vitamin K antagonists, other anticoagulants or antidiabetic drugs. The safety and efficacy of the medicine in children has not yet been established.
Pregnancy and lactation:
Pregnancy is not recommended. The drug is excreted in breast milk in small amounts, which should not affect the infant, however, due to the lack of sufficient data, the use of the preparation during breastfeeding should be limited to particularly justified cases.
Side effects:
Rare: anaphylactic reactions, anaphylactoid reactions, hypersensitivity reactions (such as pruritus, erythema, urticaria), headache and dizziness, arrhythmia, tachycardia. Very rare: thrombocytopenia, intrahepatic cholestasis, increased ALT, AST and alkaline phosphatase, symptoms of angina, bleeding episodes (on the skin, mucous membranes, in the stomach, intestines), agitation, sleep disturbances. Isolated cases: severe hypersensitivity reactions (angioneurotic edema, bronchospasm, anaphylactic shock). Not known: sterile meningitis (especially in patients with connective tissue diseases), hot flushes, hypotension, nausea, vomiting, bloating, feeling of fullness, diarrhea.In severe cases, there is usually bleeding from the gastrointestinal tract, the genitourinary system, from areas of the body with numerous wounds, including post-operative wounds, due to the occurrence of bleeding risk factors. A causal relationship between pentoxifylline therapy and the occurrence of bleeding has not been established.
Dosage:
Orally, adults: 1 tabl. 2-3 times a day. In patients with severe circulatory disorders, the effect of the preparation can be accelerated by simultaneous administration of pentoxifylline orally and by intravenous infusion. In patients with low or variable blood pressure, special dosage may be necessary. In patients with impaired renal function (creatinine clearance <30 ml / min) the dose should be reduced to 50-70% of the standard dose. In patients with severe hepatic impairment, the dose should be reduced depending on the severity of the disease symptoms and the tolerance of the preparation. The preparation should be taken after a meal, tabl. swallow whole with liquid.