From the Guidelines
Trental is a medication containing the active ingredient pentoxifylline, primarily used to improve blood flow and reduce pain, cramping, and weakness in patients with peripheral artery disease (PAD). It works by decreasing blood viscosity and improving red blood cell flexibility, allowing blood to flow more easily through narrowed arteries, particularly in the legs. The typical dosage is 400 mg taken orally three times daily with meals, though extended-release formulations may be prescribed differently, as recommended by the ACC/AHA 2005 practice guidelines 1. Patients usually need to take Trental for several weeks before noticing improvement in symptoms. Common side effects include nausea, dizziness, headache, and stomach discomfort. Trental may interact with certain medications including blood thinners, so it's essential to inform your doctor about all medications you're taking. While Trental helps manage symptoms of PAD, it should be used alongside lifestyle modifications like smoking cessation, regular exercise, and proper diet for comprehensive treatment of circulatory problems. According to a pooled analysis of six small RCTs, pentoxifylline was associated with more adverse events, but the overall quality of the evidence was deemed to be low due to limitations in design and execution, and the risk of publication bias 1. However, the ACC/AHA guidelines suggest that pentoxifylline may be considered as second-line alternative therapy to cilostazol to improve walking distance in patients with intermittent claudication, with a recommended dose of 400 mg orally 3 times per day 1. It's crucial to weigh the potential benefits and risks of Trental, considering the marginal but statistically significant improvement in pain-free and maximal walking distance, as well as the potential for adverse effects 1. Ultimately, the decision to use Trental should be made on a case-by-case basis, taking into account the individual patient's needs and medical history. The use of Trental should be guided by the most recent and highest-quality evidence, prioritizing patient outcomes such as morbidity, mortality, and quality of life.
From the FDA Drug Label
Pentoxifylline Extended-Release Tablets for oral administration, contain 400 mg of the active drug Pentoxifylline is a tri-substituted xanthine derivative designated chemically as 1-(5-oxohexyl)-3,7-dimethylxanthine that, unlike theophylline, is a hemorrheologic agent, i.e. an agent that affects blood viscosity. Pentoxifylline Extended-Release Tablets are indicated for the treatment of patients with intermittent claudication on the basis of chronic occlusive arterial disease of the limbs.
Trental is another name for Pentoxifylline, a medication used to improve function and symptoms in patients with intermittent claudication due to chronic occlusive arterial disease of the limbs 2. It is a hemorrheologic agent that affects blood viscosity 2.
From the Research
What is Trental
- Trental, also known as pentoxifylline, is a xanthine analog used to treat peripheral chronic occlusive arterial disease 3.
- It acts by increasing red blood cell deformability, reducing blood viscosity, and decreasing the potential for platelet aggregation and thrombus formation 4.
- Trental is used to improve walking distance and reduce symptoms of intermittent claudication, a condition characterized by leg pain during walking due to inadequate blood flow 5, 6.
- The recommended dose of Trental is 400 mg three times daily with meals, and it is generally well tolerated with minimal side effects 3, 7.
- Studies have shown that Trental can improve pain-free walking distance and total walking distance in patients with intermittent claudication, although the evidence is not always consistent 4, 6.
Mechanism of Action
- Trental works by improving blood flow and reducing blood viscosity, which helps to increase oxygen delivery to the muscles 3, 4.
- It also has anti-inflammatory and antioxidant properties, which may contribute to its therapeutic effects 4.
- The exact mechanism of action of Trental is not fully understood, but it is thought to involve multiple pathways, including the inhibition of phosphodiesterase and the increase of cyclic adenosine monophosphate (cAMP) 7.
Clinical Uses
- Trental is approved by the US FDA for the treatment of intermittent claudication 5, 7.
- It is also used to treat other conditions, such as peripheral vascular disease, cerebrovascular disease, and sickle cell disease 4, 6.
- Trental may be used in combination with other medications, such as antiplatelet agents and vasodilators, to improve symptoms and reduce the risk of complications 5, 7.