Trental (pentoxifylline) is a xanthine derivative primarily used to help individuals with peripheral artery disease manage the pain, cramping, numbness, or weakness associated with vascular claudication. A vasoactive agent, it improves blood flow in the arms and legs.

Though less common and often off-label, Trental is also used to help treat venous ulcers and alcoholic hepatitis.

As the conditions Trental treats typically effect adults---usually older adults---the medication has not been studied in young patients and use in those under age 18 is not recommended. Likewise use while pregnant is not advisable unless the medication is crucial and no alternatives are available. Trental does pass through breast milk and breastfeeding is inadvisable if taking this product.

Taking Trental

Trental comes in tablets of 400 mg each. Tablets should not be crushed or chewed; they should be swallowed whole. Splitting tablets is okay if a doctor advises doing so, though this is unusual. Food is recommended with each dose, as is a full glass of fluid.

Treatment is remarkably similar regardless of what Trental is used to treat:

• Most patients start with 800 mg per day, taken as two 400 mg doses at evenly-spaced intervals.
• Dosage may be increased to 1200 mg per day, taken as three 400 mg doses at evenly-spaced intervals.
• Do not exceed 1200 mg per day.

Some patients notice improvements in the first two weeks to one month, but it will be closer to two months before full benefits are seen. Patients should experience fewer symptoms of vascular claudication, being able to be more physically active for longer periods without pain, cramping, numbness and other symptoms.

Assuming no serious side effects develop, patients should take the medication for at least two months before deciding it doesn't work. If Trental does help, treatment may continue indefinitely.

Precautions

Some patients are at increased risk of side effects from Trental. This doesn't mean it can't be taken, but patients should be alert for warning signs and may need more frequent doctor checkups to monitor for developing side effects. Patients at increased risk include those who:

• Are elderly
• Have low blood pressure
• Have kidney or liver impairment

Patients should also be aware that Trental is associated with bleeding and it can slow blood clotting time. Individuals with bleeding disorders or taking blood thinners should discuss risks with a doctor prior to starting treatment. All patients should be alert for unexplained bleeding, such as in stools, and changes in clotting speed. All patients should also take care to avoid unnecessary risk of injury, such as playing contact sports.

Side Effects

Most side effects from Trental, if experienced at all, are mild and transient. Relatively common side effects include:

• Abdominal discomfort
• Heartburn
• Nausea
• Bloating
• Headache
• Flushing
• Diarrhea
• Dizziness

The above are not cause for concern unless persistant or severe enough to be disruptive.

Fewer than 1 percent of patients experience more severe side effects, including:

• Bleeding
• Difficulty breathing
• Chest pain

If the above are experienced medical attention should be sought.

Patients allergic to any other xanthine derivative will likely have an allergic reaction to Trental. These patients should seek alternative treatments.

Interactions

Trental may interact with other medications; of particular concern are:

• Cimetidine
• Erythromycin
• Theophylline
• Ciprofloxacin
• Blood clotting medications
• Diabetic medications
• Blood pressure medications
• Sympathomimetic medications

The above do not necessarily rule out Trental, but doses may need to be adjusted or other medications given instead. To be on the safe side, patients should double-check with a doctor or pharmacist before taking any other medication with Trental.