Трентал®

General characteristics. Structure:

Active agent: pentoksifillina of 1.00 mg,
Excipients: lactose, starch, talc, silicon dioxide colloid, magnesium stearate.
Structure of a cover; methacrylic acid copolymer, sodium hydroxide, макрргол (полнэтиленгликоль) 8000, talc, titanium dioxide (Е 171),
Description: round biconvex tablets, coated white blossoming. Pharmzkoteraiyevtnchesky group: vazodilatiruyushchy means.

Pharmacological properties:

Pharmacodynamics. Trental improves rheological properties of blood (flowability) due to influence on patholologically the changed deformability of erythrocytes, inhibiting aggregation of thrombocytes and reduced the increased viscosity of a shelter. Trental improves microcirculation in zones of the broken blood circulation.
As active active ingredient Trental contains derivative a keantin - пе нтоксифиллин. The mechanism of its action is connected with inhibition of phosphodiesterase and accumulation of tsAMF in cells of smooth muscles of vessels and uniform elements of blood.
Having weak myotropic sosudorasslablyayushchy effect, пентоксифиллин reduces the general peripheric resistance a little and slightly expands coronary vessels.
Treatment by Trentad leads to improvement of symptomatology of disturbances brain blood circulations.
Success of treatment at occlusal damage of peripheral arteries (for example, the alternating lameness) is shown in lengthening of a distance of walking, elimination of night spasms in gastrocnemius muscles and disappearance of pains at rest.
 
Pharmacokinetics. After oral administration пентоксифиллин quickly and almost by a polyawn it is soaked up.
After almost full absorption пентоксифиллин it is metabolized. Absolute bioavailability of initial substance makes 19±13%. The main active metabolite 1-(5-shyaroksigeksit) ~ 3,7 dimethylxantine (a metabolite 1) has концентрациго in a blood plasma twice the exceeding initial concentration of a penttzheifinlii.
The elimination half-life of a pentoksifillin after peroral introduction makes 1.6 h.
Pentoksifillin is completely metabolized and more than 90% are removed through kidneys in the form of nekonjyutirovatshchy water-soluble metabolites. Removal of metabolites is late at patients with an impaired renal function.
At patients with an abnormal liver function the period полувыведенич the neptokisfillina is extended also absolute to biodostuppoyet increases.

Indications to use:

Disturbances of peripheric circulation of ateroskleretichesky genesis (for example, the alternating lameness, a diabetic angiopatiya), trophic disturbances (for example: trophic ulcers of shins, gangrene).
Disturbances of cerebral circulation (effect of cerebral atherosclerosis, as, for example, disturbances of concentration of attention, dizziness, memory impairment), ishemnchesky and postinsultny states.
Disturbances of blood circulation in a retina and a choroid of an eye, an otosclerosis, degenerative changes against the background of pathology of vessels of an inner ear and decrease in hearing.

Route of administration and doses:

The dosage, is established, the doctor according to specific features of the patient.
The usual dose makes: ONE tablet of Trental three times and days with the subsequent slow increase in a dose to 200 mg 2-3 times a day. Maximum single dose of-400 mg. The maximum daily dose - 1200 mg. Drug should be swallowed entirely in time or right after meal, washing down with enough water.
At patients with an impaired renal function (the clearance of a kreatiiii is lower than 30 ml/min.) the dosage can be lowered to 1 - 2 tablets a day.
Reduction of a dose, taking into account individual portability, is necessary at patients with a heavy abnormal liver function.
Treatment can be begun with small doses at patients with low arterial pressure, and also at the persons which are and risk group in view of possible, lowerings of arterial pressure (patients with a severe form of an ischemic heart disease or with hemodynamically significant stenoses of vessels of a head mochg). In these cases the dose can be increased only gradually.

Features of use:

Treatment should be carried out under control of arterial pressure,
At the patients with a diabetes mellitus accepting gshyuglikemichesky means
purpose of high doses can cause the expressed hypoglycemia (dose adjustment is required).
At appointment one temporarily with anti-coagulants is necessary carefully ate to merge behind indicators of coagulant system of blood.
At the patients who recently transferred an operative measure systematic control of level of hemoglobin and a hematocrit is necessary.
The entered dose has to be reduced at patients with low and unstable артержщьп ым давл е I eat with N of l.
At elderly people reduction of a dose can be required (it is raised bnodostupnost and reduction in the rate of removal).
Safety and efficiency of a pentoksifillin at children are studied insufficiently.
Smoking can reduce a therapeutic effectiveness of drug.

Side effects:

In cases when Trental is used in high doses there can be following side effects:
from a nervous system: headache, dizziness, uneasiness, Sleep disorders, spasms:
from integuments and subcutaneously about howl celluloses: a dermahemia of the person, "inflows" of blood to face skin and an upper part of a thorax, hypostases, the increased fragility of nails;
from the alimentary system: a xerostomia, anorexia, an intestines atony, pressure sense and overflow in a stomach, nausea, vomiting, diarrhea;
from a cardiovascular sitema: tachycardia, arrhythmia, cardialgia, progressing of stenocardia, lowering of arterial pressure;
from system of a hemostasis and bodies of a hemopoiesis: a leukopenia, a singing thrombocyte, a pancytopenia, bleedings from vessels of skin, mucous membranes, a stomach, intestines, a hypofibrinogenemia;
from sense bodys: vision disorder, scotoma;
allergic reactions: itch, dermahemia, urticaria, angionevroticheoky hypostasis, acute anaphylaxis.
Very seldom cases of development of aseptic meningitis, in a hepatic kolestaz and increase in activity of "hepatic" transaminases, an alkaline phosphatase meet.

Interaction with other medicines:

Pekgokeifillin is capable to strengthen депс to league with р goes and, пнглономт arterial pressure (AG1F inhibitors. nitrates).
Pentoksifillin can strengthen effect of the medicines influencing coagulant system of blood (indirect and direct aptikoagulyanta, trombolitik), antibiotics (including cephalus a dispute it is new).
Cimetidinum increases concentration of a lentoksifillin in plasma (risk a yuzpikpovepiya of side effects).
Joint appointment with other ksangnna can lead to excessive nervous excitement.
Antihyperglycemic effect of insulin or peroral anti-diabetic means can be strengthened at reception of a pentoksifillin (the increased risk of development of a hypoglycemia). Strict control of such patients is necessary.
Some patients have a concomitant use of a pentoksifillin and a teofiliin can lead to increase in level of theophylline. It can lead to increase or strengthening of side effects, connected, with theophylline.

Contraindications:

Trental should not be applied at patients:
• with hypersensitivity to a pentoksifillin. to other methylxanthines or to any of fillers;
• with massive bleedings;
• with extensive retinal apoplexies of an eye;
• with hematencephalons;
• with an acute myocardial infarction;
• aged up to 18 years;
• at pregnancy and in the period of a lactation.

With care drug should be used at patients with:
• heavy cardiac arrhythmias (risk of deterioration in arrhythmia);
• an arterial gigyutenziya (risk of a further lowering of arterial pressure, see the section "Route of Administration and Doses");
• chronic heart failure;
• peptic ulcer of a stomach and duodenum;
• the broken function of nights (the clearance of a kreatishsh is lower than 30 ml/min.) (risk of accumulation and the increased risk of development of side effects, cm, the section "Route of Administration and Doses");
• heavy abnormal liver functions (risk of accumulation and the increased risk of side effects, see the section "Route of Administration and Doses");
• after recently postponed operative measures;
• the increased bent to bleeding, for example, as a result of use of anticoagulants or at disturbances in system of a blood coagulation (risk of development of heavier bleedings).

Overdose:

Clinical picture: Е TIN spinning, desires on vomiting, falling of arterial pressure., tachycardia, arrhythmia, reddening of integuments, a loss of consciousness, a fever, are an inflection, tone and to - drive чес Kia of a spasm,
In case of the disturbances described above it is necessary to see a doctor urgently.
Symptomatic treatment: the special attention has to be sent to a pas maintenance of arterial pressure and function of breath. Convulsive attacks are removed administration of diazepam.
At emergence of the first signs of overdose (perspiration, nausea, cyanosis) immediately stop administration of drug. Provide more?, which position of the head and upper part of a trunk. Watch free passability of respiratory tracts.

Storage conditions:

To store in the dry place at a temperature not above 25 °C. To store in the place, unavailable to children!
Period of validity 4 years. Not to use drug after a period of validity.

Issue conditions:

According to the recipe

Packaging:

The tablets covered with a kishechnorastvorimy film cover of 100 mg On 10 tablets in the blister from PVC / aluminum foil. On 6 blisters together with the application instruction in a cardboard pack.