Raynaud’s phenomenon: 400 mg three to four times daily.
Livedoid vasculopathy.
Necrobiosis lipoidica: 400 mg twice daily.
Psoriasis.
Pemphigus vulgaris: 400 mg pentoxifylline + 500 mg sulfasalazine three times daily as adjunctive therapy.
Behçet disease and recuurent aphthosis.
Venous insuffciency with ulcers: 400 mg 3 times daily.
Cutaneous polyarteritis nodosa.
Schamberg’s disease.
Cutaneous and mucocutaneous leishmaniasis : djuvant to pentavalent antimony.
Pain and pruritus associated with giant keloids.
Renal pruritus: 600 mg iv
Pruritus in HIV-infected patients.
Peyronie’s disease.
Radiation induced fibrosis and burns.
Lipodermatosclerosis.
Dosage
Usual dose : 400 mg 3–4 times daily for 2–4 months to obtain the maximal therapeutic effect.
It may take up to 2–4 months to obtain the maximal therapeutic beneft from pentoxifylline.
Mechanism of action
Immune modulation
Pentoxifylline increases erythrocyte and leukocyte deformability.
Decreases endothelial leukocyte adhesion.
Decreases leukocyte responsiveness to interleukin 1 (IL-1) and TNF.
Inhibits T and B lymphocyte activation.
Decreases natural killer cell activity.
Inhibits neutrophil adhesion and activation.
Anti-fibrinolytic
Pentoxifylline increases fibroblast collagenases and decreases the production of collagen, fibronectin and glycosaminoglycan.
Hemorheological effects
It reduces platelet aggregation and activation.
It increases red blood cell deformability and decreased blood viscosity.
Anti-TNF-α effects
Inhibitor of tumor necrosis factor-α.
Other
It is a non-selective inhibitor of cyclic-3’, 5’-phospho-diesterase (PDE), leading to a broad-spectrum effect against cell proliferation and inflammation.
Monitoring
Baseline
Check if allergic to caffeine containing products (coffee, tea, colas), pentoxifylline, theobromine, theophylline or any other drugs.
Ask about anticoagulants (“blood thinners”) such as warfarin (Coumadin) and vitamins.
Ask about Kidney disease.
Ask if pt is Pregnant, planning pregnancy or lactating.
Any surgery in the near future.
Follow Up
PERIODICALLY: blood pressure monitoring.
Side effects
Used with caution in patients with severe cardiac disease.
Nausea, gastrointestinal disturbances.
Dizziness, and headache.
Contraindications
Hypersensitivity to pentoxifylline or xanthine derivatives.
Recent retinal or cerebral hemorrhage.
Interactions
There may be an interaction between pentoxifylline and any of the following: