Trental - instructions for use, ratings, analogs and release forms (tablets of 100 mg and 400 mg injections in ampoules 5 ml) drugs for treatment of circulatory disorders in adults, children and pregnant
In this article, you can read the instructions for using the drug Trental. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Trental in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Trental with available structural analogues. Use for the treatment of circulatory disorders and trophic disorders in adults, children, as well as in pregnancy and lactation.
Trental - vasodilating drug, improves microcirculation, angioprotector, xanthine derivative. Trental improves the rheological properties of blood (fluidity) by affecting the pathologically altered erythrocyte deformability, inhibiting platelet aggregation and decreasing the increased blood viscosity. Improves microcirculation in areas of impaired blood circulation.
The mechanism of action of Pentoxifylline (the active substance of the drug Trental) is associated with inhibition of phosphodiesterase and the accumulation of cAMP in the cells of the smooth muscles of blood vessels and blood cells.
Providing 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 cerebral circulation disorders.
The success of treatment in the occlusal lesion of peripheral arteries (for example, intermittent claudication) is manifested in the elongation of the walking distance, the elimination of night cramps in the gastrocnemius muscles and the disappearance of pain at rest.
Pharmacokinetics
After oral administration, pentoxifylline is almost completely absorbed from the digestive tract.After almost complete absorption, pentoxifylline is metabolized. More than 90% is excreted by the kidneys in the form of unconjugated water-soluble metabolites.
Indications
- peripheral circulatory disorders of atherosclerotic origin (eg, intermittent claudication), diabetic angiopathy, trophic disorders (eg, shin ulcers, gangrene);
- disorders of cerebral circulation (consequences of cerebral atherosclerosis, such as impaired concentration, dizziness, memory impairment), ischemic and post-insult conditions;
- frostbite;
- postthrombotic syndrome;
- circulatory disorders in the retina and choroid of the eye;
- otosclerosis, degenerative changes on the background of the pathology of the vessels of the inner ear and hearing loss.
Forms of release
Tablets of 100 mg.
Tablets 400 mg (Trental 400).
Concentrate for the preparation of a solution for infusions (injections in ampoules) of 5 ml.
Instructions for use and dosage
Pills
The dose is set individually, according to the characteristics of the patient.
The drug is prescribed by mouth for 100 mg (1 tablet) 3 times a day, followed by a gradual increase in the dose to 200 mg 2-3 times a day. The maximum single dose is 400 mg. The maximum daily dose is 1200 mg.Tablets should be swallowed whole during or immediately after meals, with plenty of water.
In patients with impaired renal function (QC less than 30 ml / min), the dose should be reduced to 1-2 tablets per day.
In patients with severe impairment of liver function, a dose reduction should be taken taking into account the individual tolerability of the drug.
In patients with low blood pressure, as well as in people at risk because of the possible reduction in blood pressure (patients with severe CAD or with hemodynamically significant stenosis of the brain vessels), treatment can be initiated in small doses, in which case the dose should be increased gradually.
Ampoules
The dose and schedule of application are determined by the severity of circulatory disorders, and also taking into account the individual drug tolerance and patient characteristics.
The drug is administered intravenously in the form of infusions 2 times a day, in the morning and in the afternoon. A single dose (per 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 a 0.9% solution of sodium chloride or Ringer's solution.
Compatibility with other infusion solutions should be tested separately; Only transparent solutions can be used.A dose of 100 mg should be administered for at least 60 minutes. Depending on the concomitant diseases (heart failure), there may be a need to reduce the amount administered. In such cases it is recommended to use a special infuser for controlled infusion.
After daily infusion, 2 tablets of Trental 400 may be prescribed. If 2 infusions are separated by a longer interval, then 1 tablet of Trental 400 from the additionally assigned two can be taken earlier (at about noon).
If, due to clinical conditions, the implementation of intravenous infusion is possible only once a day, additionally after it, 3 tablets of Trental 400 (2 tablets at noon and 1 tablet in the evening) can be prescribed.
Prolonged 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, with the individual dose can be calculated by the formula: 0.6 mg per kg of body per hour. The daily dose of the drug, calculated in this way,will make up for a patient with a body weight of 70 kg 1000 mg, for a patient with a body weight of 80 kg - 1150 mg.
Side effect
- headache;
- dizziness;
- anxiety;
- sleep disorders;
- convulsions;
- aseptic meningitis;
- hyperemia of the facial skin;
- blood rushes to the skin of the face and upper chest;
- edema;
- increased brittleness of nails;
- anorexia;
- intestinal atony;
- feeling of pressure and overflow in the area of the stomach;
- nausea, vomiting;
- diarrhea;
- tachycardia;
- arrhythmia;
- heartache;
- a decrease in blood pressure;
- leukopenia, thrombocytopenia, pancytopenia;
- bleeding from the vessels of the skin, mucous membranes, stomach, intestines;
- impaired vision;
- itching;
- hyperemia of the skin;
- hives;
- angioedema;
- anaphylactic shock.
Contraindications
- massive bleeding;
- extensive hemorrhage in the retina of the eye;
- hemorrhage in the brain;
- acute myocardial infarction;
- porphyria;
- age to 18 years;
- pregnancy;
- lactation period (breastfeeding);
- hypersensitivity to the components of the drug;
- hypersensitivity to other methylxanthines.
For intravenous administration (additionally) - arrhythmias, expressed atherosclerosis of the coronary or cerebral arteries, uncontrolled arterial hypotension.
Application in pregnancy and lactation
The drug is contraindicated for use in pregnancy and lactation (breastfeeding).
Use in children
Trental is contraindicated in children and adolescents under the age of 18 years (efficacy and safety of use not proven).
special instructions
Treatment should be carried out under the control of blood pressure.
In patients with diabetes mellitus taking hypoglycemic drugs, the administration of the drug in high doses can cause severe hypoglycemia (dose adjustment is required).
At appointment simultaneously with anticoagulants it is necessary to watch carefully indicators of a coagulating system of a blood.
In patients who have recently undergone surgical intervention, systematic monitoring of hemoglobin and hematocrit levels is necessary, the administered dose should be reduced in patients with low and unstable blood pressure.
In elderly people, a dose reduction may be required (increased bioavailability and reduced rate of excretion).
Smoking can reduce the therapeutic effectiveness of the drug.
Use in Pediatrics
The safety and efficacy of Trental in children are not well understood.
Drug Interactions
Pentoxifylline is able to enhance the effect of drugs that lower 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 concentration of pentoxifylline in the plasma (risk of side effects).
Co-administration with other xanthines can lead to excessive nervous excitement.
It is possible to increase the hypoglycemic action of insulin or oral hypoglycemic agents when taking Trental (an increased risk of developing hypoglycemia). If combined therapy is required, strict monitoring of the patients' condition is required.
In some patients, simultaneous administration of pentoxifylline and theophylline may lead to an increase in the concentration of theophylline in the blood plasma. This can lead to an increase or increase in the side effect associated with theophylline.
Analogues of the drug Trental
Structural analogs for the active substance:
- Agapurin;
- Agapurin retard;
- Arbiflex;
- Vazonite;
- Pentamon;
- Pentylin;
- Pentylin forte;
- Pentohexal;
- Pentoxifylline;
- Pentomer;
- Radomine;
- Ralofect;
- Trenpental;
- Flexitale.
Similar medicines:
Other medicines:
- Alflutop - instructions for use, reviews, analogues and forms of release (injections in ampoules for injections of 1 and 2 ml) of the drug for the treatment of arthrosis and osteochondrosis in adults, children and pregnancy
- Dioxydin - instructions for use, analogs, reviews and release forms (solution in ampoules for inhalation and topical use (in the nose) 0.5% and 1%, ointment 5%) of the drug for the treatment of sinusitis in adults, children and pregnancy
- But-shpa - instructions for use, analogs, reviews and release forms (tablets 40 mg, 80 mg forte, injections in ampoules for injection) of a drug for the treatment of spasms and pain in adults, children and pregnancy