Trental: instructions for use. How long can I take trental

Trental is a drug from the group of angioprotectors, the action of which is aimed at improving microcirculation (blood circulation in the capillaries). The drug contains the substance pentoxifylline. There are three release forms for this product:

Tablets of 100 mg of active ingredient each;
Tablets of 400 mg of active ingredient each;
Solution for injection 5 ml - 1 ml contains 20 mg of the active substance.

Indications for use Trental

Trental is indicated for a number of diseases, among them the pathology of the spinal column. These include the following:

spinal stroke;
Atherosclerosis of the vessels of the spine;
Pronounced bruises of the spine and its structures.

Contraindications to the use of Trental

Trental is contraindicated for use in the following conditions and diseases:

Children under 18;
lactation period;
Pregnancy;
tendency to bleed;
Myocardial infarction, acute period;
Heart failure;
low blood pressure (hypotension);
kidney failure;
Liver failure;
Ulcer of the stomach and duodenum;
Allergy to the drug and its components;
Heart rhythm disturbances;
Surgical intervention less than a week ago before the start of treatment with Trental.

How Trental works

Getting into the systemic circulation, Trental immediately goes to the affected capillaries. So the active substance of the drug restores the elasticity of the walls of erythrocytes (red blood cells), inhibits increased platelet clotting, improves blood flow by reducing its viscosity. Also, the drug somewhat expands the walls of blood vessels by reducing spasm in them.

Trental normalizes metabolism in the tissues of the spine and its structures, restores gas exchange. Restores blood flow through the vessels of the spinal cord after a stroke, and also restores nerve conduction, due to proper nutrition and blood supply to the nerve endings in the affected area.

How to use Trental

Trental tablets

Trental tablets should be taken orally, without chewing or breaking, after meals, 100-400 mg 2-3 times a day. The maximum daily dosage is 1200 mg. The course of treatment is selected individually and can range from 2 weeks to several months.

Trental in the form of a solution for injection

The solution for injection is intended for intravenous administration, drip or jet. To prepare a dropper, physiological saline or 5% glucose is mixed with 1-6 ampoules of Trental and this mixture is administered within 1 hour. Multiplicity of reception - 1-2 times a day. The maximum daily dosage is 12 ampoules (1200 mg).

For jet administration, 1 ampoule is administered for 5 minutes 1-2 times a day.

Side effects of Trental

In extremely rare cases, Trental may cause side effects. The main ones include:

Stomach ache;
Vomiting accompanied by nausea;
Diarrhea, constipation or their alternation;
An attack of angina pectoris (squeezing short-term pain behind the sternum);
Increased heart rate;
Decreased blood pressure;
itchy skin;
Quincke's edema;
Headache;
Anaphylactic shock;
Dizziness;
Insomnia at night and drowsiness during the day;
Increased nervousness;
convulsions;
Violation of vision.

If side effects occur, it is necessary to stop taking the drug, contact your doctor, rinse the stomach and, if necessary, take symptomatic drugs.

Nausea;
Vomiting coffee grounds (a sign of stomach bleeding)
Decreased blood pressure numbers;
Dizziness;
Increased heart rate;
fainting;
convulsions;
Increase in body temperature.

If there are signs of an overdose with Trental, it is necessary to wash the stomach, take symptomatic drugs and intestinal sorbents.

special instructions

During pregnancy and during breastfeeding, Trental is contraindicated. If treatment with Trental is necessary, breastfeeding should be discontinued.

For children under 18 years of age, the use of this drug is contraindicated, because there is no reliable data on its effect on the development of the child.

The intake of alcoholic beverages does not affect the properties of Trental.

Trental (INN - pentoxifylline) is an original drug from the group of vasodilators from the Indian division of the world famous pharmaceutical company Sanofi. The first experience with the use of trental dates back to 1972, when it was used to treat intermittent claudication. In addition to the vasodilator, the drug has antiplatelet (prevents platelets from adhering to each other) and angioprotective (protecting blood vessels) action. Due to its ability to improve blood flow, reduce platelet aggregation, stimulate capillary circulation and make red blood cells more elastic, trental has found wide application in various circulatory pathologies. The main "weapon" of trental - pentoxifylline - in its chemical "pedigree" is very close to theophylline and theobromine. All its pharmacological advantages are due to the exclusive possession of the mystery of the inhibitory effect on type 4 phosphodiesterases, which entails an increase in the concentration of cAMP in platelets and ATP in erythrocytes against the background of a decrease in the content of calcium ions in cells. Numerous clinical studies conducted according to all the rules of evidence-based medicine testify to the ability of trental to have a purely positive effect on microcirculation and blood circulation in general. And it cannot be otherwise: after all, this drug is able to dilate blood vessels, simultaneously reducing their total and peripheral resistance, increase stroke and minute blood volumes without a significant change in heart rate.

The concentration of cAMP increases not only in platelets, but also in the smooth muscle cells of the vascular walls, which leads to their relaxation.

As already mentioned, trental is a branded original drug. In the mid-2000s of the last century, on the basis of the Yaroslavl State University, a study was made of the rheological properties of trental in comparison with generic pentoxifylline preparations. At the same time, the original drug proved to be a more pronounced antiplatelet agent (46%) than generics (20-35%). Without exception, all drugs studied reduced the size and rate of formation of aggregates, but only trental showed a persistent and significant decrease in all characteristics of aggregation.

Trental is available in three dosage forms: tablets, prolonged-release tablets and a concentrate for the preparation of a solution for intravenous and intra-arterial administration. The frequency of administration and dosing regimen are set by the attending physician according to the individual characteristics of each individual patient. During the course of treatment with the use of trental, it is recommended to control blood pressure, and if the patient has recently undergone surgery, then systematic monitoring of hemoglobin and hematocrit levels is shown in the load. An important clarification: with intravenous administration of trental, the patient must be in a supine position.

Pharmacology

Microcirculation improver, angioprotector, dimethylxanthine derivative. Pentoxifylline reduces blood viscosity, causes platelet disaggregation, increases the elasticity of erythrocytes (by affecting the pathologically altered erythrocyte deformability), improves microcirculation and increases the oxygen concentration in tissues. It increases the concentration of cAMP in platelets and ATP in erythrocytes with simultaneous saturation of the energy potential, which in turn leads to vasodilation, a decrease in peripheral vascular resistance, an increase in stroke volume and minute blood volume without a significant change in heart rate.

Expanding the coronary arteries, increases the delivery of oxygen to the myocardium, expanding the vessels of the lungs, improves blood oxygenation. Increases the tone of the respiratory muscles (intercostal muscles and diaphragm).

In / in the introduction, along with the above action, leads to an increase in collateral circulation, an increase in the volume of flowing blood through a unit section.

Increases the concentration of ATP in the brain, favorably affects the bioelectric activity of the central nervous system. Improves microcirculation in areas of impaired blood supply.

With occlusive lesions of the peripheral arteries (intermittent claudication), it leads to a lengthening of the walking distance, elimination of night cramps of the calf muscles and pain at rest.

Pharmacokinetics

After oral administration, it is well absorbed from the gastrointestinal tract. There is little metabolism during the "first pass" through the liver. Binds to erythrocyte membranes. It undergoes biotransformation first in erythrocytes, then in the liver. Some metabolites are active. T 1 / 2 from the plasma of the unchanged substance is 0.4-0.8 hours, metabolites - 1-1.6 hours. After 24 hours, most of the dose is excreted in the urine as metabolites, a smaller part (about 4%) - through the intestines.

The excretion of pentoxifylline is reduced in elderly patients and in liver diseases.

Release form

Tablets, enteric-coated film-coated white, round, biconvex.

Excipients: lactose, starch, talc, colloidal silicon dioxide, magnesium stearate.

Shell composition: methacrylic acid copolymer, sodium hydroxide, macrogol (polyethylene glycol) 8000, talc, titanium dioxide (E171).

10 pieces. - blisters (6) - packs of cardboard.

Dosage

Apply in / a (stream or drip), in / in (stream or drip), in / m, inside. The dose and treatment regimen are set individually.

Interaction

Pentoxifylline may potentiate the action of antihypertensive drugs.

Against the background of parenteral use of pentoxifylline in high doses, it is possible to increase the hypoglycemic effect of insulin in patients with diabetes mellitus.

With simultaneous use with ketorolac, an increased risk of bleeding and / or an increase in prothrombin time is possible; with meloxicam - increased risk of bleeding; with sympatholytics, ganglioblockers and vasodilators - a decrease in blood pressure is possible; with heparin, fibrinolytic drugs - increased anticoagulant action.

Cimetidine significantly increases the concentration of pentoxifylline in the blood plasma, and therefore, with simultaneous use, the likelihood of side effects may increase.

Side effects

From the side of the central nervous system: headache, dizziness; anxiety, sleep disturbances; convulsions.

Dermatological reactions: flushing of the skin of the face, flushing of blood to the skin of the face and upper chest, swelling, increased brittleness of the nails.

On the part of the digestive system: dry mouth, loss of appetite, intestinal atony, exacerbation of cholecystitis, cholestatic hepatitis, increased activity of hepatic transaminases and alkaline phosphatase.

On the part of the organ of vision: blurred vision, scotoma.

From the side of the cardiovascular system: tachycardia, arrhythmia, cardialgia, progression of angina pectoris, lowering blood pressure.

From the hemopoietic system: thrombocytopenia, leukopenia, pancytopenia.

From the blood coagulation system: hypofibrinogenemia; bleeding from the vessels of the skin, mucous membranes, stomach, intestines.

Allergic reactions: itching, skin hyperemia, urticaria, angioedema, anaphylactic shock.

Indications

Peripheral circulatory disorders (including with intermittent claudication) associated with chronic occlusive circulatory disorders in the arterial vessels of the lower extremities. Ischemic cerebrovascular accident, ischemic stroke and post-stroke conditions; cerebral atherosclerosis (dizziness, headache, memory impairment, sleep disturbances), dyscirculatory encephalopathy, viral neuroinfection (prevention of possible microcirculation disorders). IHD, condition after myocardial infarction. diabetic angiopathy. Acute circulatory disorders in the retina and choroid, acute ischemic neuropathy of the optic nerve. Otosclerosis, degenerative changes against the background of the pathology of the vessels of the inner ear with a gradual decrease in hearing. COPD, bronchial asthma. Impotence of vascular origin.

Contraindications

Acute myocardial infarction, porphyria, massive bleeding, hemorrhagic stroke, retinal hemorrhage, pregnancy, lactation. For intravenous administration (optional) - arrhythmias, severe atherosclerosis of the coronary or cerebral arteries, uncontrolled arterial hypotension.

Hypersensitivity to pentoxifylline and other xanthine derivatives.

Application features

Use during pregnancy and lactation

Adequate and well-controlled clinical studies of the safety of the use of pentoxifylline during pregnancy have not been conducted.

Pentoxifylline and its metabolites are excreted in breast milk. If necessary, use during lactation should stop breastfeeding.

Application for violations of liver function

In severe violations of liver function, correction of the dosing regimen of pentoxifylline is required.

Application for violations of kidney function

In case of impaired renal function, correction of the dosing regimen of pentoxifylline is required.

Use in children

Use with caution in children and adolescents under the age of 18 years (efficacy and safety have not been studied).

special instructions

Use with caution in the lability of blood pressure (tendency to arterial hypotension), chronic heart failure, peptic ulcer of the stomach and duodenum (for oral administration), after recent surgery, with liver and / or kidney failure, in children and adolescents under the age of 18 years (efficacy and safety have not been studied).

In case of impaired renal function or severe impaired liver function, correction of the dosing regimen of pentoxifylline is required.

During treatment, the level of blood pressure should be monitored.

With simultaneous use with antihypertensive agents, insulin, oral hypoglycemic drugs, a dose reduction of pentoxifylline may be required.

With simultaneous use with anticoagulants, blood coagulation parameters should be carefully monitored.

Tablets "Trental", what do they help? The drug has vasodilating properties, reduces blood viscosity. The drug "Trental" instructions for use recommends taking with a stroke, encephalopathy.

Pharmacological properties

The active substance that is part of the drug "Trental", from which it helps with circulatory abnormalities, reduces platelet aggregation and blood viscosity, improves the elasticity of red blood cells. With regular intake of the drug, adenosine monophosphate accumulates in the blood and blood vessels. The agent has a myotropic and vasodilating effect, improves blood properties.

The drug is well absorbed in the gastrointestinal tract. Its highest plasma concentration is observed 60 minutes after ingestion. The active substance is completely metabolized by the liver and excreted through the kidneys.

Composition and form of release

Produced in the form of tablets and solution for infusion. The active element of the Trental tablets, from which the medicine helps with heart problems, is pentoxifylline. Its content in capsules reaches 100 mg. Better absorption of the drug is facilitated by: starch, silicon dioxide, magnesium stearate, etc. The concentrate for solution for infusion contains 20 mg of pentoxifylline per 1 ml. The tablets of prolonged action "Trental" 400 include 400 mg of the active substance.

Injections, tablets "Trental": what helps the drug

Indications for use are as follows:

ischemic stroke;

Raynaud's disease;

encephalopathy;

angioneuropathy;

trophic ulcers;

insufficiency of blood circulation in the retina and inner ear;

respiratory diseases;

frostbite;

sexual dysfunction due to circulatory problems.

Contraindications

The drug "Trental" instructions for use and reviews of doctors are forbidden to use when:

hemorrhages in the retina;

hypersensitivity to the composition of the Trental tablets, from which an allergy develops;

hemorrhagic stroke;

pregnancy;

breastfeeding;

tendency to bleed.

Caution during therapy should be observed in patients with gastric and intestinal ulcers, with poor functioning of the liver or kidneys, lability of blood pressure, after surgical operations.

The drug "Trental": instructions for use

Use of injections

The injection solution is injected into a vein by drip or jet. The infusion composition is diluted in a solution of glucose, sodium chloride. The drug must be administered at a rate of 100 mg per hour. The daily dose varies from 100 to 600 mg. The drug is administered 1-2 times a day.

In complex forms of circulatory disorders, droppers are performed within 24 hours. In this case, the maximum amount of the drug should not exceed 12 years. The dose is calculated individually for each patient with the calculation of his body weight per 1 kg accounts for 06 mg of the solution.

Injections "Trental" in a vein are done within 5 minutes. The solution is administered 1-2 times a day at a dose of 100 mg. The patient must lie down during the procedure. It is allowed to combine the solution in tablet form.

Tablets "Trental": from what and how to take

The volume of the prescribed drug and the duration of therapy is determined by a specialist for each patient. As a rule, 6-8 tablets are drunk per day. This form of the drug is used as part of complex therapy or to continue treatment after injections. The maximum daily volume of the drug should not exceed 12 years.

Instructions for use "Trental 400"

Long-acting tablets are prescribed to be taken 3 times a day, 1 capsule. The maximum daily dose is 12 g.

Side effects

The drug "Trental", analogues of this drug are well tolerated by patients. This is indicated by patient reviews. However, side effects from the food, cardiac, vascular, hematopoietic, nervous systems can be observed:

irritability, angina pectoris, nausea, vomiting;

pancytopenia, edema, redness of the skin, anxiety;

arrhythmia, gastric overcrowding, thrombocytopenia, scotoma;

flushing of the skin of the face, urticaria, headache, decreased pressure;

anorexia, leukopenia, visual disturbances, angioedema;

dizziness, cardialgia, xerostomia, hypofibrinogenemia;

sleep disturbance, tachycardia, intestinal atony, vascular bleeding;

brittle nails, itching, anaphylactic shock.

drug interaction

The drug enhances the effect of anticoagulants, cephalosporin antibiotics (cefoperazone, cefotetan, cefamandol), thrombolytic drugs. Also, the drug increases the effectiveness of insulin, which reduce pressure, hypoglycemic agents. The combined use of pentoxifylline with Cimetidine leads to an increase in blood levels and provokes the development of negative effects.

Analogues

"Trental" can be replaced with drugs such as:

"Pentilin".

"Latren".

"Pentoxifylline".

"Agapurin".

"Vazonite".

Price where to buy

The cost of the drug in Kyiv reaches 31-111 hryvnia. (Trental 400 mg (pentoxifylline) No. 20 tablets (pack) AVENTIS PHARMA Ltd. (India)).

Opinions of patients and doctors

People who took the Trenatal remedy give different reviews about its actions. They indicate the effectiveness of the drug when prescribed according to indications. But the overall positive impression is spoiled by reviews of side effects. Often, after taking medication, nausea, headache, increased blood pressure, sleep is disturbed.

active substance: pentoxifylline;

1 ml of solution contains 20 mg of pentoxifylline;

Excipients: sodium chloride, water for injection.

Dosage form

Solution for injection (for intravenous infusion and slow intravenous injection).

Basic physical and chemical properties: clear colorless solution.

Pharmacotherapeutic group

Peripheral vasodilators. ATX code C04A D03.

Pharmacological properties

Pharmacodynamics.

Pentoxifylline is a derivative of methylxanthine. The mechanism of action of pentoxifylline is associated with the inhibition of phosphodiesterase and the accumulation of cAMP in vascular smooth muscle cells, blood cells, as well as in other tissues and organs. Pentoxifylline inhibits the aggregation of platelets and erythrocytes, increases their flexibility, reduces the increased concentration of fibrinogen in the blood plasma and enhances fibrinolysis, which reduces blood viscosity and improves its rheological properties. In addition, pentoxifylline has a weak myotropic vasodilating effect, somewhat reduces the total peripheral vascular resistance and has a positive inotropic effect. As a result of the use of pentoxifylline, microcirculation and tissue oxygen supply improve, most of all in the limbs, the central nervous system, and moderately in the kidneys. The drug slightly dilates the coronary vessels.

Pharmacokinetics.

The main pharmacologically active metabolite 1-(5-hydroxyhexyl)-3,7-dimethylxanthine (metabolite I) is determined in blood plasma at a concentration that is 2 times the concentration of the unchanged substance and is in a state of reverse biochemical equilibrium with it. In conjunction with this, pentoxifylline and its metabolite should be considered as an active whole. The half-life of pentoxifylline is 1.6 hours.

Pentoxifylline is completely metabolized, more than 90% is excreted by the kidneys in the form of non-conjugated water-soluble polar metabolites. Less than 4% of the administered dose is excreted in the feces. In patients with severely impaired renal function, the excretion of metabolites is slowed down. In patients with impaired liver function, an increase in the half-life of pentoxifylline was noted.

Indications

Atherosclerotic encephalopathy; ischemic cerebral stroke; encephalopathy; peripheral circulation disorders caused by atherosclerosis, diabetes mellitus (including diabetic angiopathy), inflammation; trophic disorders in tissues associated with damage to the veins or impaired microcirculation (post-thrombophlebitic syndrome, trophic ulcers, gangrene, frostbite); obliterating endarteritis; angioneuropathy (Raynaud's disease); circulatory disorders of the eye (acute, subacute, chronic circulatory failure in the retina and choroid of the eye); dysfunction of the inner ear of vascular origin, accompanied by hearing loss.

Contraindications

Trental ® is contraindicated:

patients with hypersensitivity to pentoxifylline, to other methylxanthines or to any of the excipients of the drug Trental ® ;
patients with massive bleeding (risk of increased bleeding);
patients with extensive retinal hemorrhage, with cerebral hemorrhage (risk of increased bleeding). If during treatment with pentoxifylline a retinal hemorrhage occurs, the use of the drug should be stopped immediately;
patients in the acute period of myocardial infarction;
patients with stomach ulcers and / or intestinal ulcers;
patients with hemorrhagic diathesis.

Interaction with other medicinal products and other forms of interaction

The blood sugar-lowering effect of insulin or oral antidiabetic agents may be enhanced. Therefore, patients receiving medical treatment for diabetes mellitus should be carefully monitored.

In the post-marketing period, cases of increased anticoagulant activity have been reported in patients who were simultaneously treated with pentoxifylline and antivitamin K. When pentoxifylline is prescribed or the dosage is changed, it is recommended to monitor anticoagulant activity in this group of patients.

Trental ® may enhance the hypotensive effect of antihypertensive drugs and other drugs that can cause a decrease in blood pressure.

The simultaneous use of pentoxifylline and theophylline in some patients may lead to an increase in the level of theophylline in the blood. Therefore, it is possible to increase the frequency and increase the manifestations of adverse reactions of theophylline.

In some patients, simultaneous use with ciprofloxacin may lead to an increase in the concentration of pentoxifylline in the blood serum. As a result, the frequency and severity of adverse reactions associated with the simultaneous use of drugs may increase.

Potential additive effect with platelet aggregation inhibitors: through increased risk of bleeding, concomitant use of platelet aggregation inhibitors (eg, clopidogrel, eptifibatide, tirofiban, epoprostenol, iloprost, abciximab, anagrelide, NSAIDs other than selective COX-2 inhibitors, acetylsalicylitative [ASA/LAS ], ticlopidine, dipyridamole) with pentoxifylline should be used with caution.

Simultaneous use with cimetidine can increase the concentration of pentoxifylline and metabolite I in the blood plasma.

Application features.

At the first signs of an anaphylactic / anaphylactoid reaction developing, treatment with Trental ® should immediately stop the infusion and seek medical help.

In the case of the use of the drug Trental ®, patients with chronic heart failure should first reach the phase of circulatory compensation.

In patients suffering from diabetes and receiving treatment with insulin or oral antidiabetic agents, when using high doses of the drug Trental ®, it is possible to increase the effect of these drugs on blood sugar levels (see section "Interaction with other drugs and other types of interactions"). In these cases, the dose of insulin or oral antidiabetic agents should be reduced and the patient should be especially carefully looked after.

In patients with systemic lupus erythematosus (SLE) or other connective tissue diseases, pentoxifylline should be prescribed only after a thorough analysis of the possible risks and benefits.

Since during treatment with pentoxifylline there is a risk of developing aplastic anemia, regular monitoring of the complete blood count is necessary.

In patients with renal insufficiency (creatinine clearance less than 30 ml / min) or severe liver dysfunction, the excretion of pentoxifylline may be delayed. Proper monitoring is required.

Particular attention is needed for:

patients with severe cardiac arrhythmias;
patients with arterial hypotension;
patients with severe atherosclerosis of cerebral and coronary vessels, especially with concomitant arterial hypertension and cardiac arrhythmias. In these patients, when taking the drug, attacks of angina pectoris, arrhythmias and arterial hypertension are possible;
patients with renal insufficiency (creatinine clearance below 30 ml / min);
patients with severe liver failure;
patients with a high tendency to bleeding due, for example, to treatment with anticoagulants or bleeding disorders. Concerning bleedings - see the section "Contraindications";
patients who have recently undergone surgical treatment (increased risk of bleeding, in connection with which systematic monitoring of hemoglobin and hematocrit levels is necessary);
patients for whom a decrease in blood pressure is a high risk (for example, patients with severe coronary heart disease or stenosis of the vessels that supply blood to the brain);
patients who are simultaneously receiving treatment with pentoxifylline and antivitamin K or inhibitors of platelet aggregation (see section "Interaction with other drugs and other forms of interaction");
patients who are simultaneously receiving treatment with pentoxifylline and antidiabetic agents (see section "Interaction with other medicinal products and other forms of interaction");
patients who are simultaneously receiving treatment with pentoxifylline and ciprofloxacin (see section "Interaction with other medicinal products and other forms of interaction").
patients who are simultaneously receiving treatment with pentoxifylline and theophylline (see section "Interaction with other medicinal products and other forms of interaction").

Use during pregnancy or lactation

Pregnancy

There is not enough experience with the use of the drug in pregnant women. For this, it is not recommended to prescribe Trental ® during pregnancy.

Lactation

Pentoxifylline passes into breast milk in small amounts. If treatment with Trental® is prescribed, breastfeeding should be discontinued.

The ability to influence the reaction rate when driving vehicles or operating other mechanisms

Does not affect.

Dosage and administration

Intravenous infusions are the most effective forms of parenteral administration of the drug and are better tolerated. The dosage regimen is determined by the doctor and depends on the severity of circulatory disorders, body weight and tolerability of treatment. Infusion can be carried out only if the solution is clear.

1. Intravenous infusion of 100-600 mg of pentoxifylline in 100-500 ml of Ringer's lactate solution, 0.9% sodium chloride solution or 5% glucose solution 1-2 times a day. The duration of intravenous drip infusion is 60-360 minutes, that is, the administration of 100 mg of pentoxifylline should last at least 60 minutes. The infusion may be supplemented with oral administration of Trental ® (400 mg) on the basis that the maximum daily dose (infusion and oral) is 1200 mg.

2. In severe condition of the patient (especially with constant pain, with gangrene or trophic ulcers), it is possible to infuse Trental ® within 24 hours. With this scheme of administration, the dose should be determined at the rate of 0.6 mg / kg / hour. The daily dose calculated in this way for a patient with a body weight of 70 kg is 1000 mg, for a patient with a body weight of 80 kg - 1150 mg. Regardless of the patient's body weight, the maximum daily dose is 1200 mg. The volume of the infusion solution is calculated individually, taking into account concomitant diseases, the patient's condition, and averages 1-1.5 liters per day.

3. In some cases, the drug can be used by intravenous injection of 5 ml (100 mg). The injection should be performed slowly over 5 minutes with the patient in the supine position.

The duration of the parenteral course of treatment is determined by the doctor who carries out the treatment. After the patient's condition improves, it is recommended to continue treatment using the tablet form of the drug Trental ® .

Children

There is no experience with the use of Trental® in children.

Overdose

The initial symptoms of an acute overdose of pentoxifylline are nausea, dizziness, or a decrease in blood pressure. In addition, symptoms such as fever, agitation, hot flashes (hot flashes), tachycardia, loss of consciousness, areflexia, arrhythmia, tonic-clonic convulsions, and coffee grounds vomit as a sign of gastrointestinal bleeding may develop.

Overdose treatment

In order to treat acute overdose and prevent the occurrence of complications, general and specific intensive medical supervision and therapeutic measures are necessary.

Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Trental in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Trental in the presence of existing structural analogues. Use for the treatment of circulatory disorders and trophic disorders in adults, children, as well as during pregnancy and lactation.

Trental is a vasodilator drug that improves microcirculation, an angioprotector, a xanthine derivative. Trental improves the rheological properties of blood (fluidity) by affecting the pathologically altered deformability of erythrocytes, inhibiting platelet aggregation and reducing increased blood viscosity. Improves microcirculation in areas of impaired circulation.

The mechanism of action of pentoxifylline (the active substance of the drug Trental) is associated with the inhibition of phosphodiesterase and the accumulation of cAMP in vascular smooth muscle cells and blood cells.

Having a weak myotropic vasodilating effect, pentoxifylline somewhat reduces OPSS and slightly dilates the coronary vessels.

Treatment with Trental leads to an improvement in the symptoms of cerebrovascular accidents.

The success of treatment for occlusive lesions of the peripheral arteries (for example, intermittent claudication) is manifested in the lengthening of the walking distance, the elimination of nocturnal cramps in the calf muscles and the disappearance of pain at rest.

After oral administration, pentoxifylline is almost completely absorbed from the gastrointestinal tract. After almost complete absorption, pentoxifylline is metabolized. More than 90% is excreted by the kidneys in the form of unconjugated water-soluble metabolites.

peripheral circulatory disorders of atherosclerotic origin (eg, intermittent claudication), diabetic angiopathy, trophic disorders (eg, leg ulcers, gangrene);
disorders of cerebral circulation (consequences of cerebral atherosclerosis, such as impaired concentration, dizziness, memory impairment), ischemic and post-stroke conditions;
frostbite;
post-thrombotic syndrome;
circulatory disorders in the retina and choroid of the eye;
otosclerosis, degenerative changes against the background of the pathology of the vessels of the inner ear and hearing loss.

Tablets 100 mg.

Tablets 400 mg (Trental 400).

Concentrate for solution for infusion (injections in ampoules), 5 ml.

Instructions for use and dosage

The dose is set individually, in accordance with the characteristics of the patient.

The drug is administered orally at 100 mg (1 tablet) 3 times a day, followed by a gradual increase in dose to 200 mg 2-3 times a day. The maximum single dose The maximum daily dose Tablets should be swallowed whole during or immediately after a meal with plenty of water.

In patients with impaired renal function (CC less than 30 ml / min), the dose should be reduced to 1-2 tablets per day.

In patients with severe hepatic impairment, a dose reduction is necessary, taking into account the individual tolerability of the drug.

In patients with low blood pressure, as well as in those at risk due to a possible decrease in blood pressure (patients with severe ischemic heart disease or with hemodynamically significant cerebral stenosis), treatment can be started in small doses, in these cases the dose should be increased gradually.

The dose and regimen of application are determined by the severity of circulatory disorders, as well as taking into account the individual tolerance of the drug and the characteristics of the patient.

The drug is administered intravenously in the form of infusions 2 times a day, in the morning and afternoon. A single dose (for 1 infusion) is 200 mg of pentoxifylline (2 ampoules of 5 ml) or 300 mg of pentoxifylline (3 ampoules of 5 ml) in 250 ml or 500 ml of 0.9% sodium chloride solution or Ringer's solution.

Compatibility with other infusion solutions should be tested separately; only clear solutions can be used. The 100 mg dose should be administered over at least 60 minutes. Depending on concomitant diseases (heart failure), it may be necessary to reduce the injected volume. In such cases, it is recommended to use a special infusator for controlled infusion.

After a daily infusion, an additional 2 tablets of Trental 400 may be prescribed. If the 2 infusions are separated by a longer interval, then 1 tablet of Trental 400 of the additional two prescribed may be taken earlier (approximately at noon).

If, due to clinical conditions, intravenous infusion is only possible once a day, additionally after it, 3 tablets of Trental 400 can be prescribed (2 tablets at noon and 1 tablet in the evening).

Long-term intravenous infusion of Trental for 24 hours is indicated in more severe cases, especially in patients with severe pain at rest, with gangrene or trophic ulcers (3-4 stages according to Fontaine).

The dose of Trental for parenteral administration within 24 hours, as a rule, should not exceed 1200 mg, while the individual dose can be calculated using the formula: 0.6 mg per kg of body per hour. The daily dose of the drug, calculated in this way, will be 1000 mg for a patient with a body weight of 70 kg, for a patient with a body weight of 80 kgmg.

headache;
dizziness;
anxiety;
sleep disorders;
convulsions;
aseptic meningitis;
flushing of the skin of the face;
flushes of blood to the skin of the face and upper chest;
swelling;
increased fragility of nails;
anorexia;
intestinal atony;
feeling of pressure and fullness in the stomach;
nausea, vomiting;
diarrhea;
tachycardia;
arrhythmia;
heartache;
decrease in blood pressure;
leukopenia, thrombocytopenia, pancytopenia;
bleeding from the vessels of the skin, mucous membranes, stomach, intestines;
visual impairment;
skin hyperemia;
hives;
angioedema;
anaphylactic shock.

massive bleeding;
extensive hemorrhages in the retina;
hemorrhage in the brain;
acute myocardial infarction;
porphyria;
age up to 18 years;
pregnancy;
lactation period (breastfeeding);
hypersensitivity to the components of the drug;
hypersensitivity to other methylxanthines.

For intravenous administration (optional) - arrhythmias, severe atherosclerosis of the coronary or cerebral arteries, uncontrolled arterial hypotension.

The drug is contraindicated for use during pregnancy and lactation (breastfeeding).

Trental is contraindicated in children and adolescents under the age of 18 years (efficacy and safety of use has not been proven).

In diabetic patients taking hypoglycemic agents, the administration of the drug in high doses can cause severe hypoglycemia (dose adjustment is required).

When administered simultaneously with anticoagulants, it is necessary to carefully monitor the indicators of the blood coagulation system.

In patients who have recently undergone surgery, systematic monitoring of hemoglobin and hematocrit levels is necessary, the administered dose should be reduced in patients with low and unstable blood pressure.

In the elderly, dose reduction may be required (increase in bioavailability and decrease in excretion rate).

Pediatric use

The safety and efficacy of Trental in children have not been adequately studied.

Pentoxifylline is able to enhance the effect of drugs that reduce blood pressure (ACE inhibitors, nitrates).

Trental can enhance the effect of drugs that affect the blood coagulation system (indirect and direct anticoagulants, thrombolytics), antibiotics (including cephalosporins).

Cimetidine increases the plasma concentration of pentoxifylline (risk of side effects).

Co-administration with other xanthines can lead to excessive nervous excitement.

It is possible to increase the hypoglycemic effect of insulin or oral hypoglycemic agents when taking Trental (increased risk of hypoglycemia). If combination therapy is necessary, strict monitoring of the patient's condition is required.

In some patients, the simultaneous administration of pentoxifylline and theophylline may lead to an increase in the concentration of theophylline in the blood plasma. This may lead to an increase or increase in the side effects associated with theophylline.

Analogues of the drug Trental

Structural analogues for the active substance:

News edited by: admin016, 14:31

Trental

Release forms

Sale: prescription

Shelf life: 48 months.

Sale: prescription

Storage: 15-25C (room temperature)

Shelf life: 48 months.

Trental instruction

The concentration of cAMP increases not only in platelets, but also in the smooth muscle cells of the vascular walls, which leads to their relaxation.

Reviews of doctors about trental

Excellent drug "Trental". It is used not only by vascular surgeons. It has also found wide application in neurosurgery. We use it in the treatment of craniocerebral trauma, with trauma to peripheral nerves and compression radiculopathy against the background of intervertebral hernia. There is both an infusion form and a tablet form, which is very convenient.

The drug is of high quality, well tolerated, only you need to slowly drip. After intravenous administration, you need to switch to tablets for 2-3 months for the best effect. It is prescribed for patients with chronic and acute vascular insufficiency. In my practice I often use and see the result.

Sometimes with a quick introduction, nausea, dizziness, weakness may appear, but it quickly passes. The main thing is a slow introduction.

A good classic drug for the treatment of chronic ischemia of the lower extremities, significantly increases the distance of pain-free walking.

Quite often a feeling of dizziness, nausea. There is no experience of comparison with celastasol yet.

I use both in infusion and tablet forms, more often in combination with both, 2 courses per year.

An excellent drug, constantly used in practice in patients with arterial pathology, chronic venous ulcers, CHF and other microcirculatory disorders. It completely replaces the use of infusion therapy, suitable for the treatment of patients on an outpatient basis.

Side effects include lowering blood pressure and shortness of breath.

An excellent vascular remedy, proven over the years. I have been using this drug for the treatment of cerebral vessels and radiculitis for a long time. Indeed, some patients experience dizziness on first intravenous administration. But as a rule, this effect is absent with repeated administration. I recommend to use in treatment.

At a relatively affordable price, the reliable drug "Trental" has been proven over the years and by doctors of various profiles: orthopedic traumatologists, neurologists, rheumatologists, phlebologists.

A common side effect is dizziness.

It is necessary to titrate the dose - start with half the dose of the target. Often only the effect of the first dose is noted.

An excellent drug for the treatment of circulatory disorders in the vessels of the lower extremities. Always prescribe to patients drip 5.0 per saline, drip for hours, because the half-life is fast. Usually 10 droppers with the transition to tablet forms.

In case of pathology of the cardiovascular system, consultation with a cardiologist is mandatory.

An effective angioprotective agent, improves microcirculation, leads to a lengthening of the walking distance, elimination of night cramps in the calf muscles and pain at rest.

In rare cases, adverse reactions have been observed. In persons under the age of 18, efficacy and safety have not been adequately studied. The cost of the drug leaves much to be desired.

It is recommended to take into account the peculiarities of the interaction of the drug with other drugs. It should be used with caution in the lability of blood pressure. In case of impaired renal function or severe violations of liver function, correction of the dosing regimen is required.

Many forms of release - the efficiency is excellent, it is prescribed in specialized departments by the river! It seems to me that I don’t need advertising for the drug - it really improves microcirculation! Of course, not a panacea, but still an excellent drug. Patients are mostly satisfied, available in ampoules and tablets.

Patient reviews about trental

He took Trental as directed by a doctor with a seasonal illness of hypothermia of the extremities, as a result of which there was severe swelling of the arms and legs, itching and ulcers. Nothing helped, the torment lasted until the temperature outside rose to positive. As soon as I started using Trental, I immediately felt relief. The drug not only relieves unpleasant symptoms, it acts on the cause of the disease. I suspect that all this is due to thick blood, and "Trental" "dilutes" it.

I developed cervical chondrosis from prolonged work on the computer. From time to time, exacerbations occur, during which headaches and severe dizziness appear, pressure jumps. Previously, she was treated with other drugs, and for the last 3 years the neurologist has been prescribing Trental. First I do 10 droppers, then I take pills for a long time. Very satisfied with the drug. After a course of treatment for exactly a year, nothing bothers me, although the doctor prescribed droppers 2 times a year. If the medicine is administered by drip rapidly, then the pressure is greatly reduced and the head is spinning. With slow input, I have no adverse reactions.

2-3 hours after taking the pill - something is wrong with my head, I can't put my brains together. like a vegetable. Although I hope that it will help with cramps, pain in the back and legs.

Pretty good drug. I took it when there was a problem with the sensitivity of both hands and feet, and specifically numbness of the fingertips, feet, palms. Trental helps if taken long enough and in combination with other drugs. But, compared with analogues, which are no worse, this is a rather expensive medicine.

The doctor prescribed a course of droppers with the drug "trental". Diagnosis: frostbite of the fingers of the left hand of the first degree (I will not go into details of this case). No catastrophic side effects were observed during the course. The maximum I can complain about is a slight itching in the area of the fingers and the hand as a whole at the end of the course of treatment. At the beginning, the pain, of course, was terrible, but I don’t think that this is due to the use of this drug. After the treatment, I felt good, surprisingly, even the appearance of my fingers returned to normal. I did not have to repeat the course of treatment with trental, I am very grateful to the doctor.

My back hurt so much, it was impossible to stand at all. The doctors said that the nerve root near the spine was inflamed, prescribed droppers with the drug Trental. The pain from the back is gone, even the legs began to hurt less, but the side effects also made themselves felt. Constant headache and slightly nauseous. When the IV course ended, the nausea went away, and the back pain did not return, so Trental helped me, albeit in a not very pleasant way.

Application instruction of trental

pharmachologic effect

In / in the introduction, along with the above action, leads to an increase in collateral circulation, an increase in the volume of flowing blood through a unit section.

Increases the concentration of ATP in the brain, favorably affects the bioelectric activity of the central nervous system. Improves microcirculation in areas of impaired blood supply.

With occlusive lesions of the peripheral arteries (intermittent claudication), it leads to a lengthening of the walking distance, elimination of night cramps of the calf muscles and pain at rest.

Pharmacokinetics

The excretion of pentoxifylline is reduced in elderly patients and in liver diseases.

Release form, composition and packaging

Tablets, enteric-coated film-coated white, round, biconvex.

Excipients: lactose, starch, talc, colloidal silicon dioxide, magnesium stearate.

Shell composition: methacrylic acid copolymer, sodium hydroxide, macrogol (polyethylene glycol) 8000, talc, titanium dioxide (E171).

10 pieces. - blisters (6) - packs of cardboard.

Dosing regimen

drug interaction

Pentoxifylline may potentiate the action of antihypertensive drugs.

Against the background of parenteral use of pentoxifylline in high doses, it is possible to increase the hypoglycemic effect of insulin in patients with diabetes mellitus.

Cimetidine significantly increases the concentration of pentoxifylline in the blood plasma, and therefore, with simultaneous use, the likelihood of side effects may increase.

Side effect

From the side of the central nervous system: headache, dizziness; anxiety, sleep disturbances; convulsions.

Dermatological reactions: flushing of the skin of the face, flushing of blood to the skin of the face and upper chest, swelling, increased brittleness of the nails.

On the part of the organ of vision: blurred vision, scotoma.

From the side of the cardiovascular system: tachycardia, arrhythmia, cardialgia, progression of angina pectoris, lowering blood pressure.

From the hemopoietic system: thrombocytopenia, leukopenia, pancytopenia.

From the blood coagulation system: hypofibrinogenemia; bleeding from the vessels of the skin, mucous membranes, stomach, intestines.

Allergic reactions: itching, skin hyperemia, urticaria, angioedema, anaphylactic shock.

Indications

Contraindications for use

Hypersensitivity to pentoxifylline and other xanthine derivatives.

Use during pregnancy and lactation

Adequate and well-controlled clinical studies of the safety of the use of pentoxifylline during pregnancy have not been conducted.

Pentoxifylline and its metabolites are excreted in breast milk. If necessary, use during lactation should stop breastfeeding.

Application for violations of liver function

In severe violations of liver function, correction of the dosing regimen of pentoxifylline is required.

Application for violations of kidney function

In case of impaired renal function, correction of the dosing regimen of pentoxifylline is required.

Use in children

Use with caution in children and adolescents under the age of 18 years (efficacy and safety have not been studied).

special instructions

In case of impaired renal function or severe impaired liver function, correction of the dosing regimen of pentoxifylline is required.

During treatment, the level of blood pressure should be monitored.

With simultaneous use with antihypertensive agents, insulin, oral hypoglycemic drugs, a dose reduction of pentoxifylline may be required.

With simultaneous use with anticoagulants, blood coagulation parameters should be carefully monitored.

Trental

Trental is a medicine that belongs to the pharmacological group of angioprotective drugs.

It contributes to the normalization of blood circulation processes, improves microcirculation, as well as cellular respiration, positively affects the rheological characteristics of blood. Trental is indicated in the fight against frostbite, trophic disorders, disorders of the circulatory processes in the brain, as well as the choroid of the eye.

This drug contributes to the speedy recovery after a stroke. Normalizes the patient's condition in ischemic and post-thrombotic syndrome.

Clinical and pharmacological group

A drug that improves microcirculation. Angioprotector.

Terms of sale from pharmacies

Can be bought with a doctor's prescription.

How much does Trental cost in pharmacies? The average price is at the level of 600 rubles.

Composition and form of release

Trental is available in the following forms:

enteric film-coated tablets, 100 mg: biconvex, round, white (10 pcs in blisters, 6 blisters in a carton box);
prolonged-release tablets (Trental 400), 400 mg: biconvex, oblong, white, engraved with ATA on one side (10 pcs. in blisters, in a carton box 2 blisters);
concentrate for solution for infusion: colorless, almost transparent (5 ml in ampoules, 5 ampoules in a cardboard box).

Composition per 1 enteric film-coated tablet:

active ingredient: pentoxifylline - 100 mg;
auxiliary components: starch, colloidal silicon dioxide, talc, magnesium stearate, lactose;
film shell: macrogol 8000, methacrylic acid copolymer, titanium dioxide, sodium hydroxide, talc.

Composition per 1 prolonged-release film-coated tablet:

active ingredient: pentoxifylline - 400 mg;
auxiliary components: hydroxyethylcellulose, magnesium stearate, povidone, talc;
film shell: macrogol 6000, hydroxypropyl methylcellulose, titanium dioxide, benzyl alcohol, talc.

Composition per 1 ml of concentrate for solution for infusion:

active substance: pentoxifylline - 20 mg;
auxiliary components: water for injection, sodium chloride.

pharmachologic effect

The active substance of the drug reduces the ability of platelets to stick together, thereby improving blood circulation in small vessels. In addition, Trental reduces the content of fibrinogen protein, which significantly affects blood viscosity and improves the condition of erythrocyte cell membranes, increasing their resistance to deformation.

There is also a general relaxing effect of the drug on the vascular wall, which allows you to reduce resistance and increase the volume of blood entering the organs. Also, the drug improves the functional state of the central nervous system. Trental has no effect on the heart rate.

The therapeutic effect is achieved an hour after taking the drug in the form of tablets. Its neutralization occurs in the liver, excretion - through the kidneys. The decay products also have a therapeutic effect and have a similar effect.

Indications for use

What are these pills for? Trental has the following indications:

Raynaud's disease and other angioneuropathy;
pathology of peripheral circulation;
gangrene, trophic ulcers and frostbite;
pathology of the respiratory system with obstruction;
dyscirculatory encephalopathy, ischemic stroke and encephalopathy of atherosclerotic origin;
circulatory failure in the vessels of the retina and in the area of the inner ear;
pathology of sexual function associated with circulatory failure.

Contraindications

The use of Trental 100 mg tablets is contraindicated in certain pathological and physiological conditions of the patient's body, which include:

Increased blood pressure (arterial hypertension), which is difficult to treat with drugs.
Hypersensitivity to any chemical compounds derived from methylxanthines.
Hypersensitivity to any of the components of the drug.
Volumetric bleeding of various localization in the body.
Acute myocardial infarction (death of a section of the heart muscle) of the myocardium.
Extensive hemorrhages localized in the retina.
Severe disturbances in the rhythm of contractions of the heart (arrhythmia).
Hemorrhages in the tissue structures of the brain.
Pregnancy at any stage of the course, lactation (breastfeeding).

With caution, this drug is used in patients with a concomitant increase in blood pressure, which is amenable to drug control, a pronounced violation of the functional state of the liver and kidneys, chronic insufficiency of the contractile function of the heart, impaired hemostasis (blood coagulation), which is accompanied by an increased tendency to bleed, including including and against the background of the use of drugs of the pharmacological group, indirect anticoagulants, as well as after surgical interventions undergone in the recent past.

Before prescribing the drug, the doctor must make sure that there are no contraindications.

Appointment during pregnancy and lactation

Pentoxifylline passes into breast milk in small amounts. If necessary, the use of the drug during lactation should stop breastfeeding (given the lack of experience with the use).

Dosage and method of application

As indicated in the instructions for use, Trental is taken orally. Tablets should be swallowed whole with plenty of water during or immediately after a meal.

The dose is set by the doctor in accordance with the individual characteristics of the patient.

The average dose of the drug for oral administration is 100 mg (1 tab.) 3 times / day, followed by a slow dose increase to 200 mg (2 tab.) 2-3 times / day. The maximum single dose The maximum daily dose

In patients with impaired renal function (CC less than 30 ml / min), the dose may be reduced by 1-2 tablets / day.

Dose reduction based on individual tolerability is necessary in patients with severe hepatic impairment.

Treatment can be started in small doses in patients with low blood pressure, as well as in patients at risk due to a possible decrease in blood pressure (patients with severe coronary artery disease or with hemodynamically significant cerebrovascular stenosis). In these cases, the dose can only be increased gradually.

Side effects

The use of high doses of Trental or intravenous infusion in excess of the recommended infusion rate can cause the following side effects on organs and systems:

sense organs: scotoma, blurred vision;
nervous system: dizziness, headache, convulsions, sleep disturbances, anxiety;
digestive system: anorexia, xerostomia, intestinal atony;
cardiovascular system: arrhythmia, tachycardia, cardialgia, decrease in blood pressure, progression of angina pectoris;
hypersensitivity reactions: skin flushing, itching, urticaria, anaphylactic shock, angioedema;
skin and subcutaneous fat: edema, flushing of the skin of the face, increased fragility of nails, flushing of blood to the face and upper chest;
hemostasis system and hematopoietic organs: thrombocytopenia, leukopenia, pancytopenia, bleeding (from mucous membranes, vessels of the skin, intestines, stomach), hypofibrinogenemia.

Very rarely, there have been cases of intrahepatic cholestasis, an increase in the activity of liver enzymes, as well as the occurrence of aseptic meningitis.

Taking Trental tablets can cause a feeling of pressure and fullness in the stomach, nausea, vomiting and diarrhea from the digestive system.

Overdose

Manifested by tonic-clonic convulsions, agitation, drowsiness, tachycardia, fainting, lowering blood pressure, dizziness, weakness, coffee grounds vomiting and other signs of gastrointestinal bleeding. An emergency gastric lavage, the introduction of enterobrents, activated charcoal, and post-syndromic therapy are required.

special instructions

Before you start using the drug, read the special instructions:

Treatment should be carried out under the control of blood pressure.
Smoking may reduce the therapeutic efficacy of the drug.
The safety and efficacy of pentoxifylline in children have not been well studied.
When prescribing the drug Trental simultaneously with anticoagulants, it is necessary to control the parameters of the blood coagulation system.
In patients who have recently undergone surgery, regular monitoring of hemoglobin and hematocrit is necessary.
In patients with low and unstable blood pressure, the dose of pentoxifylline should be reduced.
In elderly patients, it may be necessary to reduce the dose of the drug (increase in bioavailability and decrease in the rate of excretion of pentoxifylline).
In patients with diabetes mellitus taking hypoglycemic agents, the administration of the drug in high doses can cause severe hypoglycemia (dose adjustment of hypoglycemic agents and glycemic control may be required).

Given the possible side effects (for example, dizziness), care should be taken when driving vehicles and engaging in potentially hazardous activities.

Interaction with other drugs

Trental may potentiate the action of antihypertensive drugs.

Against the background of the use of pentoxifylline parenterally in high doses, it is possible to increase the hypoglycemic effect of insulin in patients with diabetes mellitus.

In combination with ketorolac, the risk of bleeding and / or an increase in prothrombin time is increased; with meloxicam - increased risk of bleeding; with sympatholytics, ganglioblockers and vasodilators - a decrease in blood pressure is possible; with heparin, fibrinolytic drugs - increased anticoagulant action.

Cimetidine increases the concentration of pentoxifylline in the blood plasma and increases the risk of side effects.