Pentoxifylline
AGAPURIN SR 400 and АГАПУРИН SR 400 mg are different trade names for the same drug, written in Polish and Bulgarian.
Indications for use of Agapurin SR 400:
Agapurin SR 400 is intended for use in adult patients.
Before starting treatment with Agapurin SR 400, you should discuss it with your doctor or pharmacist.
The doctor should consider the benefit-to-risk ratio of using Agapurin SR 400 in patients with arterial hypotension, severe heart rhythm disorders, advanced coronary and cerebral atherosclerosis, acute myocardial infarction, diabetes, and severe renal dysfunction.
If symptoms of anaphylactic or pseudo-anaphylactic reaction occur, you should discontinue use of Agapurin SR 400 and immediately contact your doctor.
During treatment with Agapurin SR 400, patients with severe heart rhythm disorders, advanced coronary and cerebral atherosclerosis with arterial hypotension, and post-myocardial infarction should be under constant medical supervision.
Renal dysfunction (creatinine clearance <30 ml min) and severe liver dysfunction may cause delayed elimination of pentoxifylline.
In such cases, the dose of Agapurin SR 400 should be reduced, and the patient should be under constant medical supervision.
Patients with an increased tendency to bleeding, using Agapurin SR 400 concurrently with vitamin K antagonists, platelet aggregation inhibitors, or antidiabetic drugs, should be under constant medical supervision.
Patients using Agapurin SR 400 concurrently with antidiabetic drugs should be under constant medical supervision (see "Agapurin SR 400 and other medicines", below).
In patients with low blood pressure or heart disease, after administration of Agapurin SR 400, a sudden drop in blood pressure and, rarely, back pain or chest pain may occur.
Therefore, during treatment, blood pressure should be monitored.
Patients using Agapurin SR 400 concurrently with ciprofloxacin should be under constant medical supervision (see "Agapurin SR 400 and other medicines", below).
Patients using pentoxifylline concurrently with theophylline should be under constant medical supervision (see "Agapurin SR 400 and other medicines", below).
You should tell your doctor about all medicines you are currently taking or have recently taken, as well as any medicines you plan to take.
Agapurin SR 400 may enhance the effect of antihypertensive medicines (including angiotensin-converting enzyme inhibitors) or other medicines that lower blood pressure (e.g., nitrates).
In patients treated with insulin or oral antidiabetic medicines, after administration of Agapurin SR 400, a decrease in blood glucose levels may occur.
Therefore, patients with diabetes should be under constant medical supervision.
In patients using pentoxifylline concurrently with vitamin K antagonists, cases of enhanced anticoagulant effect have been reported. When starting or modifying the dose of Agapurin SR 400 in these patients, close monitoring of anticoagulant activity is recommended.
Due to the increased risk of bleeding, caution should be exercised in patients using pentoxifylline concurrently with platelet aggregation inhibitors, such as clopidogrel, eptifibatide, tirofiban, epoprostenol, iloprost, abciximab, anagrelide, non-steroidal anti-inflammatory drugs other than selective COX-2 inhibitors, acetylsalicylic acid (aspirin) or lysine acetylsalicylate, ticlopidine, dipyridamole.
In some patients, concurrent use of pentoxifylline and theophylline may increase theophylline levels in the blood and enhance theophylline-related side effects.
In some patients, concurrent use of pentoxifylline and ciprofloxacin may increase pentoxifylline levels in the blood. Therefore, an increase in the frequency and severity of side effects related to concurrent use of these two active substances may occur.
Concurrent use of Agapurin SR 400 with cimetidine may increase pentoxifylline and its active metabolite levels in the blood.
See section 3.
If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, you should consult your doctor before using this medicine.
This medicine is not recommended for use in pregnant women and breastfeeding mothers.
In breastfeeding women, the doctor will decide whether the potential benefits outweigh the risks to the child.
This medicine does not affect the ability to drive or use machines.
This medicine should always be used exactly as prescribed by your doctor. If you are unsure, you should consult your doctor or pharmacist.
The usual dose is one tablet two or three times a day.
Patients with low or variable blood pressure may require a special dosing schedule.
Dosing in patients with renal impairment
In patients with renal impairment (creatinine clearance <30 ml min), the doctor will reduce dose to 50-70% of usual recommended dose, depending on individual tolerance treatment, and recommend taking 1 or 2 tablets a day.
Dosing in patients with liver impairment
In patients with severe liver failure, the dose should be reduced.
The decision on the dose to be used is made by the treating doctor, depending on the degree of liver failure and individual tolerance to treatment.
Other
In patients with severe circulatory disorders, the effect of pentoxifylline can be accelerated by concurrent administration of Agapurin SR 400 and pentoxifylline in the form of an intravenous infusion.
There is no experience with the use of Agapurin SR 400 in children.
Method of administration
Tablets should be swallowed whole during or immediately after a meal, with a sufficient amount of water.
In case of taking a higher dose of the medicine than recommended, you should immediately consult a doctor or pharmacist.
Initial symptoms may include nausea, dizziness, rapid heartbeat, hypotension, followed by fever, agitation, hot flashes, loss of consciousness, disappearance of reflexes, convulsions, and hematemesis (vomiting blood related to gastrointestinal bleeding). Treatment of overdose is symptomatic. The patient may require intensive medical care in a hospital.
In case of overdose or accidental ingestion of the medicine by a child, you should immediately consult a doctor.
In case of accidentally missing a dose of the medicine, you should take it as soon as possible. If it is almost time for the next dose, you should take only that dose at the right time. Do not take a double dose to make up for the missed dose.
Without consulting a doctor, you should not stop using the medicine.
If you have any further doubts about using this medicine, you should consult a doctor or pharmacist.
Like all medicines, Agapurin SR 400 can cause side effects, although not everybody gets them.
You should immediately consult a doctor if you experience:
You should immediately consult a doctor if you experience a tendency to bruise and bleed, as these may be symptoms of thrombocytopenia (reduced platelet count). In such cases, during treatment with Agapurin SR 400, the patient's blood morphology should be regularly monitored.
Dose-dependent gastrointestinal side effects usually disappear after discontinuation of treatment.
Side effects may occur with the following frequency:
Common (occurring in 1 to 10 patients out of 100): nausea, vomiting, bloating, abdominal pain, diarrhea.
Uncommon (occurring in 1 to 10 patients out of 1000): dizziness, headache, blurred vision, hot flashes.
Rare (occurring in 1 to 10 patients out of 10,000): allergic skin reactions, flushing, itching, hives, increased sweating, cholestasis, increased liver enzyme activity, hypotension, tachycardia, palpitations, arrhythmias, angina pectoris, anxiety, sleep disorders, hallucinations, hypoglycemia, anaphylactic shock.
Very rare (occurring in less than 1 in 10,000 patients): aplastic anemia, thrombocytopenia, bleeding (e.g., into the skin, mucous membranes, stomach, intestines).
Unknown (frequency cannot be estimated from available data): anaphylactic reaction, pseudo-anaphylactic reaction, leukopenia or neutropenia, agitation, angioedema, rash, aseptic meningitis, gastrointestinal disorders, discomfort in the upper abdomen, feeling of fullness in the stomach, constipation, excessive salivation, decreased blood pressure, bronchospasm.
If you experience any side effects, including any side effects not listed in this leaflet, you should tell your doctor or pharmacist. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products, Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
By reporting side effects, you can help provide more information on the safety of this medicine.
The medicine should be stored out of sight and reach of children.
Store at a temperature below 25°C.
Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the month.
Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.
The active substance of the medicine is pentoxifylline, 400 mg.
Other ingredients are:
core:hypromellose 2208/15000, povidone 30, talc, magnesium stearate;
coating:Sepifilm 752 white (hypromellose, microcrystalline cellulose, polyoxyl 40 stearate, titanium dioxide), simethicone emulsion SE4, macrogol 6000.
White, smooth, round, biconvex tablets.
Pack size: 20, 50, or 100 prolonged-release tablets in blisters, in a cardboard box.
For more detailed information, you should contact the marketing authorization holder or parallel importer.
Zentiva, k.s., U Kabelovny 130, Dolní Měcholupy, 102 37 Prague 10, Czech Republic
Saneca Pharmaceuticals a.s., Nitrianska 100, 920 27 Hlohovec, Slovakia
Zentiva, k.s., U Kabelovny 130, Dolní Měcholupy, 102 37 Prague 10, Czech Republic
InPharm Sp. z o.o., ul. Strumykowa 28/11, 03-138 Warsaw
InPharm Sp. z o.o. Services sp. k., ul. Chełmżyńska 249, 04-458 Warsaw
Marketing authorization number in Bulgaria, the country of export:20060666
[Information about the trademark]
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