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Pentoxifylline
General information
Pentoxifylline (oxipentifylline) is a methylxanthine that antagonizes the vasoconstrictor effects of catecholamines and increases cyclic AMP concentrations, causing smooth muscle to relax. It has also been claimed to correct impaired microcirculation, by improving various factors that disturb blood rheology, and to reduce the generation of toxic free radicals from leukocytes during ischemic leg exercise in patients with intermittent claudication. Pentoxifylline has been used to suppress overproduction of tumor necrosis factor alfa in conditions such as falciparum malaria and rheumatoid arthritis and in transplant recipients, with varied success.
Drug studies
Comparative studies
In 52 adults with cerebral malaria who were randomized to either quinine dihydrochloride alone (n = 32) or a combination of quinine and pentoxifylline (n = 20), the addition of pentoxifylline significantly improved coma resolution time from 64 to 22 hours and reduced mortality from 25% to 10% [ ]. Three days after therapy, serum tumor necrosis factor alfa concentrations fell significantly in those who received pentoxifylline. Pentoxifylline caused no adverse reactions that necessitated withdrawal.
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