Вазодилататор. Пентоксифиллин улучшает микроциркуляцию и реологические свойства крови. Механизм действия Пентоксифиллина связан с игибированием фосфодиэстеразы и накоплением ЦАМФ в клетках гладкой мускулатуры сосудов и форменных элементов крови. Пентоксифиллин тормозит агрегацию тромбоцитов и эритроцитов, повышает их эластичность, уменьшает уровень фибриногена в плазме и усиливает фибринолиз, что уменьшает вязкость крови и улучшает ее реологические свойства. Оказывает слабое миотропное сосудорасширяющее действие. Пентоксифиллин несколько уменьшает общее периферическое сопротивление и незначительно расширяет коронарные сосуды. В целом, Пентоксифиллин вызывает улучшение микроциркуляции и снабжения тканей кислородом в ЦНС и в конечностях, в меньшей степени – в почках.
Показания к применению
Нарушения периферического кровообращения, обусловленные атеросклерозом, сахарным диабетом (диабетическая ангиопатия), воспалением
Острые и хронические нарушения мозгового кровообращения ишемического типа
Атеросклеротические и дисциркуляторные энцефалопатии
Ангионейропатии (парестезии, болезнь Рейно)
Трофические нарушения тканей вследствие нарушения артериальной или венозной микроциркуляции (трофические язвы, посттромбофлебический синдром, отморожения, гангрена)
Облитерирующий эндартериит
Острая, подострая и хроническая недостаточность кровообращения в сетчатке или в сосудистой оболочке глаза
Нарушения слуха сосудистого генеза
Противопоказания
Острый инфаркт миокарда
Массивные кровотечения
Острый геморрагический инсульт
Выраженный коронарный или церебральный атеросклероз
Выраженные нарушения ритма сердца
Кровоизлияния в сетчатке глаза
Беременность и период кормления грудью
Возраст до 18 лет
Повышенная чувствительность к пентоксифиллину, другим метилксантинам или другим компонентам готовой лекарственной формы. Следует соблюдать осторожность при назначении пентоксифиллина больным с язвенной болезнью желудка и двенадцатиперстной кишки, больным недавно перенесшим оперативное вмешательство (риск возникновения кровотечений). Больным с лабильным артериальным давлением и со склонностью к артериальной гипотензии и больным с выраженными нарушениями функций почек дозу увеличивают постепенно и подбирают индивидуально
Применение при беременности и в период грудного вскармливания
Клиническая картина: головокружение, позывы на рвоту, падение АД, тахикардия, покраснение кожных покровов, потеря сознания, повышение температуры тела (озноб), ажитация, арефлексия, тонико-клонические судороги, рвота "кофейной гущей", аритмии. Лечение передозировки симптоматическое. Особое внимание должно быть направлено на поддержание АД и функции дыхания. Судорожные припадки снимаются введением диазепама. Срочные мероприятия при возникновении тяжелых анафилактических реакций (шока): — при появлении первых признаков (потливость, тошнота, цианоз) немедленно прекратить прием препарата; — помимо других необходимых мероприятий обеспечивают более низкое положение головы и верхней части туловища и обеспечивают свободу для дыхания; — срочные медицинские мероприятия: вводят в/в эпинефрин (адреналин). При необходимости введение эпинефрина можно повторить.
Способ применения и дозы
Длительность лечения и режим дозирования Пентоксифиллина устанавливаются лечащим врачом индивидуально, в зависимости от клинической картины заболевания и получаемого терапевтического эффекта. Препарат принимают внутрь сразу после еды, не разжевывая, запивая достаточным количеством жидкости. Взрослым препарат назначают, начиная с 200 мг 3 раза/сут. Пролонгированные лекарственные формы назначают 2 раза/сут. Курс лечения 2-3 недели и более.
Побочное действие
Пентоксифиллин способен усиливать действие антигипертензивных средств и антикоагулянтов. У больных сахарным диабетом, находящихся на лечении инсулином или принимающих противодиабетические средства, Пентоксифиллин может усилить сахароснижающее действие противодиабетических средств, вплоть до возникновения гипогликемических реакций.
Передозировка
Наиболее часто при приеме Пентоксифиллина могут появляться нежелательные явления со стороны ЖКТ (тошнота, ощущение переполнения в животе, спазм желудка, рвота, понос). Иногда может возникнуть головокружение и головная боль. Изредка можно наблюдать понижение АД, стенокардию, нарушение сердечного ритма, ощущение прилива. В редких случаях реакции повышенной чувствительности наблюдались покраснения кожных покровов, зуд, крапивницу. В отдельных случаях может появляться желтуха (интрагепатический холестаз) и повышение уровня печеночных энзимов (трансаминаз, щелочной фосфатазы). В единичных случаях описывали возникновение очень тяжелых реакций сверхчувствительности - ангионевротические отеки, развивающиеся в течение нескольких минут после приема Пентоксифиллина, судорожные спазмы мускулатуры бронхов, анафилактический шок. При первых признаках реакции повышенной чувствительности необходимо срочно прекратить прием препарата и обратиться к врачу. Имеются отдельные сообщения о возможности возникновения кровотечений (в ЖКТ, в кожу, в слизистые), тромбоцитопении и апластической анемии. В связи с этим при лечении Пентоксифиллином необходимо проводить регулярный контроль картины крови.
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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