Pentoxifilin, fiole

Prospect

Compozitie
Solutie injectabila - 1 ml solutie apoasa contine 20 mg pentoxifilina.
Drajeuri continand cate 100 mg pentoxifilina 

Actiune terapeutica
Pentoxifilina este un derivat xantinic cu proprietati vasodilatatoare antiischemice prin actiune musculotropa. Actioneaza asupra arteriolelor si capilarelor, ameliorand proprietatile reologice ale sangelui. Se utilizeaza indeosebi in tratamentul tulburarilor circulatorii ale membrelor, dar si ale circulatiei cerebrale. Pentoxifilina nu are actiune stimulanta asupra SNC, spre deosebire de alti derivati metilxantinici.

Indicatii
Tulburari circulatorii periferice arteriale si venoase de natura aterosclerotica si/sau diabetica; arteriopatie cronica obliteranta (stadiul II dupa Fontaine); tulburari trofice in sindromul post-trombotic, ulcer de gamba, gangrena, degeraturi. Tulburari ale circulatiei cerebrale: sindrom ischemic, vertij, cefalee, tulburari de memorie si atentie, diminuarea capacitatii intelectuale. tulburari circulatorii la nivel ocular si al urechii interne.

Doze si mod de administrare
Tratamentul va fi individualizat in functie de starea clinica si reactivitatea bolnavului, Pentoxifilin putand fi administrat pe cale orala sau combinat (oral si parenteral).
Per oral: se administreaza in timpul sau dupa mesele principale, cu mult lichid, astfel: drajeuri - doza initiala: 3x2 drajeuri/zi; doza de intretinere: 3x1 drajeuri/zi.
Parenteral: este recomandat ca la inceputul tratamentului sa se testeze reactia individuala a pacientului, prin administrarea a 2,5 ml sol. inj. diluata cu 7,5 ml ser fiziologic. In perfuzie intravenoasa se administreaza initial o fiola in 250-500 ml solutie perfuzabila (NaCl 9 , levuloza 5%, glucoza sau inlocuitori ai masei sanguine), in timp de 90-180 min. In zilele urmatoare, dozele pot fi crescute cu cate 50 mg (2,5 ml sol. inj.), pana la max. 300 mg (15 ml)/zi. In caz de tulburari grave de circulatie se pot face perfuzii de doua ori/zi.

Contraindicatii
Hipersensibilitate cunoscuta la derivati xantinici (pentoxifilina, cofeina, teobromina, teofilina). infarct miocardic recent, hemoragii masive, scleroza cerebrala si coronariana cu hipertensiune.

Masuri de precautie
La bolnavii hipertensivi cu labilitate vasculara se vor administra doze progresive de Pentoxifilin; in insuficienta cardiaca, administrarea se va face in volume mici, mentinandu-se tratamentul cardiac suportiv; la pacientii cu clearance creatininic mai mic de 10 ml/min. Este necesara ajustarea dozei zilnice pentru a evita acumularea pentoxifilinei. In insuficienta renala, doza zilnica nu va depasi 800 mg/zi; in cazul aparitiei unei hemoragii oculare, tratamentul va fi intrerupt imediat; administrarea unei doze crescute de Pentoxifilin la bolnavii de diabet poate spori secretia de insulina, potentandu-se astfel efectul antidiabeticelor. Sarcina si alaptare: nu se administreaza in perioada de sarcina sau alaptare. Efecte asupra capacitatii de conducere auto sau de exploatare a altor masini: se evita administrarea Pentoxifilin la conducatorii auto si la persoanele cu profesii ce impun performante psihomotorii riguroase.

Reactii adverse
Cele mai frecvente sunt tulburarile gastro-intestinale (greata, voma, arsuri si/sau dureri epigastrice, diaree) si eruptiile pruriginoase (reactii cutanate alergice). Toate aceste simptome dispar la intreruperea tratamentului. in cazuri rare, la doze mari de Pentoxifilin pot sa apara: tahicardie, scaderea tensiunii arteriale, angina pectorala, senzatie de caldura. In astfel de cazuri se reduce doza zilnica sau chiar se intrerupe tratamentul. In cazuri izolate apar modificari ale tabloului sangvin, diminuarea numarului plachetelor sanguine, hemoragii ale pielii, mucoaselor si ale tractului digestiv.

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