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Pentoxifylline for venous ulcer healing

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    Pentoxifylline increases red blood cell flexibility by increasing erythrocyte ATP and cyclic nucleotide levels. It reduces the viscosity of blood by decreasing erythrocyte aggregation and stimulating fibrinolysis to reduce plasma fibrinogen concentrations.

    According to Jull Ab and colleagues, a Chchrane REvieow of 7 randomized controlled trials (RCT) showed that pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (RR 1.70, 95% CI 1.30 to 2.24). Pentoxifylline plus compression is more effective than placebo plus compression (RR 1.56, 95% CI 1.14 to 2.13). Pentoxifylline in the absence of compression appears to be more effective than placebo or no treatment (RR 2.25, 95% CI 1.49 to 3.39).

    The authors conculed that "Pentoxifylline is an effective adjunct to compression bandaging for treating venous ulcers and may be effective in the absence of compression. The majority of adverse effects were gastrointestinal disturbances".


    Dr Karamanoukian's note:  Pentoxifylline 400 mg ER given once daily is recommended in patients with venous stasis ulcers.