Haemorrheological agent (xanthine derivative)
Pregnancy: Avoid in first trimester. Use only if essential.
Pentoxifylline (Oxpentifylline)
Brand names: Trental
Adult dose
Dose: 400 mg two to three times daily with food
Route: Oral
Frequency: Two to three times daily
Max: 1200 mg/day
Peripheral vascular disease / intermittent claudication: 400 mg TDS with food. Venous leg ulcers (adjunct): 400 mg TDS for 24 weeks. Also used as adjunct in necrotising fasciitis protocols and radiation-induced fibrosis (with vitamin E).
Paediatric dose
Route: Not applicable
Frequency: Not licensed in children
Max: Not applicable
Not licensed in children.
Dose adjustments
Renal
Reduce dose if eGFR <30.
Hepatic
Reduce dose in significant hepatic impairment.
Clinical pearls
- Modest benefit in intermittent claudication — exercise rehabilitation and cardiovascular risk reduction are more important
- Mechanism: improves red cell deformability and reduces blood viscosity
- Used in radiation-induced fibrosis alongside vitamin E (tocopherol) — reasonable evidence
- Take with food to minimise GI side effects
- Evidence less compelling than cilostazol for claudication
Contraindications
- Severe cerebrovascular haemorrhage
- Acute MI
- Hypersensitivity to methylxanthines (caffeine, theophylline)
Side effects
- GI upset (nausea, vomiting, diarrhoea — take with food)
- Dizziness and headache
- Flushing
- Angina (rare)
- Arrhythmias (rare)
Interactions
- Anticoagulants and antiplatelets — increased bleeding risk
- Antihypertensives — additive hypotension
- Theophylline — additive xanthine effects
Monitoring
- Walking distance
- GI tolerance
- BP
Reference: BNFc; BNF; NICE NG19 PAD Guidelines. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways