Pentoxifylline

  • Methyl xanthine-derivative, non-specific phosphodiesterase inhibitor
  • Half-life 4-6 h
  • Extensive metabolism in liver
  • Excreted in urine
  • Pregnancy Category C
  • Oral
  • 400 mg 3-4 times a day
  • Decrease viscosity in small vessels
  • Increase erythrocyte & leukocyte deformability
  • Inhibits neutrophil 
  • Decrease platelet aggregation & activation
  • Tumor necrosis factor (TNF)- alpha inhibitor
Off-label

  • Raynaud phenomenon
  • Livedoid vasculopathy
  • Necrobiosis lipoidica
  • Venous insufficiency with ulcers
  • Oral aphthosis 
  • Pigmented purpuric dermatosis
  • Intolerance of methyl xanthine derivatives (caffeine, theophylline)
  • Recent cerebral / retinal hemorrhage
  • Nausea
  • Gastrointestinal symptoms
  • Dizziness
  • Headache
  • Substrate of CYP1A2 (major)
  • Decrease dose if renal dysfunction
  • Decrease dose if hepatic impairment
  • 2-4 months before maximum therapeutic effect
  • For venous stasis ulcer, use in combination with compression stockings