Which medications in the drug class Hemorrheologic Agents are used in the treatment of Diabetic Foot Ulcers?

Updated: Oct 15, 2020
  • Author: Tanzim Khan, DPM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Hemorrheologic Agents

Hemorrheologic agents such as pentoxifylline (Trental) improve intermittent claudication in approximately 60% of patients after 3 months. Cilostazol (Pletal) is an alternative hemorrheologic agent for patients who cannot tolerate pentoxifylline. [76] Cilostazol is contraindicated in patients with congestive heart failure. However, there is no conclusive evidence of any direct beneficial effect of either pentoxifylline or cilostazol on the healing of diabetic foot ulcers.

Pentoxifylline (Trental)

Pentoxifylline is indicated to treat intermittent claudication. It may alter rheology of red blood cells, which in turn reduces blood viscosity. Two to eight weeks of therapy may be required before symptomatic improvement occurs, and only about 60% of patients respond to this drug.

Cilostazol (Pletal)

Cilostazol is indicated to reduce symptoms of intermittent claudication, as indicated by an increased walking distance. It affects vascular beds and cardiovascular function and produces nonhomogeneous dilation of vascular beds, with greater dilation in femoral beds than in vertebral, carotid, or superior mesenteric arteries. Renal arteries were not found to be responsive to its effects. The mechanism of cilostazol involves inhibition of PDE, especially PDE III, and reversible inhibition of platelet aggregation. Patients may respond as early as 2-4 weeks after initiation of therapy, but treatment for as many as 12 weeks may be needed before a beneficial effect is experienced.


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