In the treatment of some groups of diseases quite often special drugs are used that have a vasodilating effect. One of these tools is produced under the name Trental. Instructions, reviews, analogues of the drug are discussed below.
What is the dosage form?
The instruction to "Trental 100 mg" describes two dosage forms of medicament in which it is produced. These are tablets and a solution in ampoules for the preparation of injections. The product was developed by the Indian pharmaceutical corporation Sanofi India Limited, which has a registration certificate for the drug. The same company carries out production supervision. The name "Trental" (TRENTAL) is a registered trademark, which is indicated in the Register of medicines.
In addition to the active component, additional substances are also part of the medicine. In tablets, these are:
- starch,
- silica colloidal
- lactose,
- magnesium stearate,
- talc.
Convex tablets on both sides have a rounded shape. In order for the drug to reach the intestines, where it begins its work, each tablet is coated with a special coating that dissolves when the medicine enters the intestines. This shell gives the tablets a white color, it consists of macrogol, sodium hydroxide, a copolymer of methacrylic acid, talc, titanium dioxide. All these components serve only as forming agents and have no medicinal value.
What works in the drug?
Tells all the detailed information about the drug "Trental" instructions for use. Tablets and solution for injection contain a single active substance - it is pentoxifylline. It is a derivative of purine and is a white crystalline powder. The formula of the substance is: C 13 H 18 N 4 O 3 .
It was received in 1972 by German pharmacists, then it received the trade name "Trental". Since the late 1970s, this drug has been actively used in Russia and many foreign countries as a vasodilator.
Pharmaceutical group
Some drugs, due to the active substance that works in them, belong to several pharmacological groups. So, the solution for injection and tablets "Trental" (100 mg or any other dosage) belong to the following pharmacological groups:
- antiplatelet agents;
- angioprotectors and microcirculation correctors;
- adenosergic drugs.
They are combined by a common vasodilating effect on the human body.
How does the drug work?
The active substance of Trental (the radar included the drug on its list as a vadilator) is pentoxifylline. It is a derivative of purine, which serves as the basis for many biologically significant compounds, for example, DNA and RNA, alkaloids, caffeine, taurine and many others. Pentoxifylline has an inhibitory effect on phosphodiesterase, an enzyme group that affects signaling pathways. This action lowers the level of calcium inside the cells, stabilizes the amount of cyclic guanosine monophosphate, which causes the release of more nitric oxide. This chemical compound is a direct participant in many biological processes in living organisms. For example, by stimulating the activity of soluble guanylate cyclase, nitric oxide through a chain of chemical reactions and biological transcriptions indirectly affects the relaxation of vascular smooth muscle, exerting a vadilating effect.
Pentoxifylline, being the main component of the Trental preparation (this information is also indicated in the radar), has the following effects on the cardiovascular and respiratory systems of the human body:
- inhibits the adhesion (aggregation) of platelets, and also makes them more resistant to deformation;
- improves blood rheology;
- inhibits the processes of industrial formation;
- activates blood microcirculation;
- contributes to the expansion of the coronary arteries, which increases the amount of oxygen delivered to the myocardium;
- relaxes the blood vessels of the lungs, which contributes to the improvement of blood oxygenation;
- increases the tone of the muscles involved in the breathing process (diaphragm and intercostal muscles).
It is such a wide range of actions that made it possible to include the Trental drug in the list of therapeutic agents for many diseases and pathological conditions.
Which way does the medicine go?
All the necessary information is told about the Trental 100 preparation by the application instruction. It indicates that pentoxifylline acts as the active ingredient in the drug. The drug is available in the form of enteric-coated tablets and as a solution for injection.
Once in the gastrointestinal tract, the drug begins to dissolve only in the intestine, which is due to a special protective membrane. That is why in the absorption zone into the systemic circulation, the active component is in sufficient quantity, without being exposed to the negative effects of gastric secretion.
Pentoxifylline undergoes biotransformation during the first passage through the liver, and the resulting metabolite and the starting substance are in reversible biochemical redox equilibrium, which allows us to consider them as a single active unit. Therefore, the drug has a fairly high bioavailability. The half-life is about one and a half hours. The medicine is excreted in the form of metabolites, with about 90% of them passing through the kidneys. Therefore, in patients with kidney disease, the period of elimination of the drug is somewhat slower. But if the patient suffers from a liver pathology, then the absolute bioavailability of the drug increases.
When is drug treatment indicated?
According to the radar, Trental belongs to a group of drugs that have a vasodilating effect. In this regard, it is prescribed for use in the following cases:
- peripheral arterial occlusion diseases of atherosclerotic or diabetic origin;
- trophic circulatory disorders;
- disorders in the circulatory system of the brain;
- circulatory disorders in the retina and choroid of the eye;
- pathologies caused by disorders in the vascular system of the inner ear.
If we talk about specific diseases and pathological conditions or disorders in the functioning of organs and systems, then their list will be much more extensive:
- peripheral angiopathy;
- bronchial asthma;
- atherosclerosis of limb arteries;
- cerebral atherosclerosis;
- unspecified retinal disease;
- choroid disease with unspecified etiology;
- various vascular diseases;
- ear disease on a degenerative and vascular basis;
- cerebrovascular disease, unspecified;
- gangrene;
- Dizziness
- impotence of vascular origin;
- cerebral infarction;
- coronary heart disease;
- impaired activity and attention;
- impaired stability;
- otosclerosis;
- hearing loss is different;
- intellectual-mnemonic disorders;
- memory impairment;
- chronic obstructive pulmonary disease;
- disciplinary encephalopathy;
- diabetic ulcer;
- trophic skin ulcer;
- ulcer of the lower extremity.
Also, this medicine is prescribed during rehabilitation periods after cerebral infarction, cerebrovascular diseases, as well as strokes.
If the medicine should not be taken?
Instructions for use "Trental 100" indicates cases where it can not be assigned. These are diseases and conditions such as:
- hypersensitivity to pentoxifylline, as well as other methylxanthines, an allergy is possible to other components of the drug;
- lactase deficiency;
- cerebral hemorrhages;
- massive hemorrhages in the retina (due to the risk of their amplification);
- galactose intolerance;
- acute myocardial infarction;
- serious bleeding (due to an increased risk of their further development);
- glucose-galactose malabsorption syndrome.
Scientific research on the use of Trental by children, women who are breast-feeding and bearing a child has not been conducted. There is no confirmed data on the safe use of this drug in the treatment of these groups of patients. That is why the drug is prohibited for use by children, pregnant and lactating women.
Caution will not hurt
There are conditions and diseases in which the medication can be taken under the strict supervision of a specialist with the utmost care, carefully monitoring the patient's condition. According to the radar and instructions to "Trental", these pathologies include:
- serious, pathological cardiac arrhythmias (due to the risk of potentiation of arrhythmia);
- arterial hypotension (due to the possibility of its further amplification);
- chronic heart failure;
- peptic ulcer of the stomach and duodenum;
- impaired functional of the kidneys and liver (due to the possible accumulation of the active component in the patient's body and increased manifestations of side effects of the drug);
- recent surgical interventions.
Possible negative consequences
What side effects does Trental 400 have according to the instructions? Reviews of patients and an annotation to the drug show that taking the medication can provoke a number of undesirable manifestations. These include:
- agitation;
- anorexia;
- arrhythmia;
- intestinal atony;
- insomnia;
- bronchospasm;
- hyperemia of the skin;
- hypersalivation;
- hypofibrinogenemia;
- headache;
- dizziness;
- diarrhea;
- constipation;
- itchy skin;
- bleeding
- xerostomia (dry mouth);
- leukopenia;
- aseptic meningitis;
- visual impairment;
- neutropenia;
- swelling
- angioedema;
- pancytopenia;
- anaphylactic / anaphylactoid reactions;
- vomiting
- scotoma;
- decrease in blood pressure;
- angina pectoris;
- cramps
- skin rash;
- tachycardia;
- nausea;
- anxiety;
- thrombocytopenia;
- heaviness in the stomach;
- increased activity of hepatic transaminases;
- increased activity of alkaline phosphatase;
- intrahepatic cholestasis;
- shock anaphylactic;
- erythema.
There is no official data on the incidence of adverse reactions during the course of therapy with Trental. But some patients mention in their reviews such unpleasant consequences of its use as lowering blood pressure and problems with the gastrointestinal tract.
How to take the drug?
According to the recommendations of the radar, Trental, like all medications, should be prescribed by the attending physician. He will recommend the correct dose and dosage regimen. But usually the Trental drug is recommended to be taken 3 times a day, 100 mg each, gradually, slowly increasing the dosage of the drug to 200 mg at a time. It should be borne in mind that the maximum dose of the drug at a time should not exceed 400 mg, and the daily dose is 1200 mg.
If the patient suffers from impaired renal function, then in a day he can take no more than 2 tablets. The same gentle treatment regimen is prescribed for patients with liver problems.
If the patient suffers from hypotension or is at risk for such patients, then the minimum dosage of the drug is prescribed, followed by its slow increase.
Tablets are taken without chewing, during or immediately after a meal, drinking plenty of water.
Overdose
For the drug "Trental 400", the use must be recommended by the attending physician. Only strict adherence to the prescription of a specialist will help the patient defeat the pathological condition. An overdose of this medicine manifests itself in the form of:
- arrhythmias;
- Dizziness
- falling blood pressure;
- redness of the skin;
- loss of consciousness;
- coffee grounds vomit,
- tachycardia;
- tonic-clonic seizures;
- nausea
To avoid such undesirable consequences, the drug is taken only on the recommendation of a doctor.
Joint treatment with several agents
Discloses important information about the drug "Trental" instructions for use. Tablets have a vasodilating effect, and therefore they can not be taken with nitrates or ACE inhibitors, as this can provoke a decrease in blood pressure to a critical level.
Trental enhances the action of anticoagulants, antibiotics, thrombolytics. Also, this tool can provoke a hypoglycemic attack, if it is thoughtlessly used in therapy with hypoglycemic drugs.
The combined use of ciprofloxacin, theophylline with pentoxifylline can cause an increase in the negative effect of these drugs.
How to buy and store medicine?
According to the instructions, Trental (400 mg or any other dosage) is a prescription drug and can only be dispensed from pharmacies according to a special prescription prescribed by your doctor. The shelf life of this medicine is 4 years, after which it can not be taken for any purpose, but should be disposed of as household waste. Store tablets at room temperature, without sunlight, out of the reach of children.
What do patients say?
All important details are contained in the instructions for use about the drug. Reviews about Trental (400 mg or 100 mg) prove that the medicine helps to solve problems caused by impaired functional vascular system. Some patients note that during treatment they developed headaches and dizziness. There are reports that tablets cause sleep disturbances. For many patients, Trental is a rather expensive medicine, because its average cost per pack of 60 tablets (dosage in 100 mg) is about 500 rubles.
The opinion of experts
The use of Trental tablets is widely used to solve vascular problems. They have been used for about 40 years in medical practice and have not lost their relevance to this day. Experts note this as a huge "plus" of the drug, because the therapeutic effectiveness of Trental is confirmed by so many years of practice in the treatment of a wide range of diseases. Experts also note a rather rare development of side effects with adequate prescription of therapy, taking into account the health status of a particular patient.
Are there any analogues?
In the pharmacy network, you can find drugs that have the same active substance pentoxifylline, as in the drug under the trade name "Trental". These are generics that are named for the active component. Also, such drugs as Agapurin, Vazonit, Pentilin, Radomin are based on this active component. They are synonymous with the Trental drug (this information is also displayed in the radar) and have the same indications and contraindications for use. Which of the medicines should be used in the treatment of a disease, only the attending physician decides. Self-treatment with these drugs is unacceptable!