The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications are of some benefit in treating PAD and generally fall into two categories:

  • Medications that improve flow through narrowed arteries
  • Medications that "thin" the blood so that it doesn't clot as readily

Prescription Medications

Pentoxifylline (Trental)

Antiplatelet agents

  • Cilostazol (Pletal)
  • Clopidogrel (Plavix)
  • Ticlopidine (Ticlid)
  • Dipyridamole (Persantine)

Clot-busting drugs (thrombolytic drugs)

  • Recombinant tissue plasminogen activator (rt-PA, alteplase)

Anticoagulants

  • Warfarin (Coumadin)
  • Heparin (Calciparin, Liquaemin)

Over-the-Counter Medications

Aspirin

OTC pain medications

Prescription Medications

Pentoxifylline

Common brand name: Trental

Pentoxifylline improves blood flow by lowering its viscosity (thickness) and making red blood cells more flexible.

Possible side effects include:

  • Indigestion
  • Nausea
  • Dizziness

Antiplatelet Agents

Common names: cilostazol (Pletal), clopidogrel (Plavix), ticlopidine (Ticlid), dipyridamole (Persantine)

Among the many anti-platelet agents currently available, cilostazol is the only one specifically labeled for use in the treatment of intermittent claudication. Significant improvements in walking distance have been noted with its use, but they may take up to 12 weeks to appear. Cilostazol should not be taken if you have heart failure.

Possible side effects include:

  • Worsening heart failure
  • Headache
  • "Cold" symptoms (runny nose, sore throat)
  • Bowel changes

Clot-busting Drugs (Thrombolytic Drugs)

Common names: recombinant tissue plasminogen activator ( rt-PA, Alteplase )

Given by IV, this drug is only given to patients in the hospital.

Of the several thrombolytic ("clot busting") agents on the market, none is specifically FDA approved for treating peripheral vascular occlusion. These drugs work in the complex chemistry of blood clotting to dissolve the chemicals that hold blood clots together. But because there is a fine balance between blood clotting and blood thinning, thrombolysis must be very carefully controlled.

Possible side effects include:

  • Bleeding, especially in the area of stomach ulcers or recent surgical sites.
  • Rare allergic reactions
  • Serious heart and lung events

Anticoagulants

Common names: heparin (Calciparin, Liquaemin), warfarin (Coumadin)

Heparin is given by IV or injection while in the hospital. Once at home, an oral anticoagulant, such as warfarin, may be used.

These drugs work immediately to prevent blood from clotting, rather than dissolving a clot after it has formed. They are therefore technically preventive rather than curative. If you are at substantial risk of another blood clot, these agents may be used.

Possible side effects include:

  • Bleeding
  • Allergic reactions
  • Thrombocytopenia (too few platelets)

Over-the-Counter Medications

Aspirin

Aspirin is almost universally recommended for circulatory diseases due to its safety, low cost, and proven effect at reducing heart attacks and other occlusive vascular diseases.Various doses may be prescribed by your physician. Lower doses are less likely to cause the gastrointestinal disturbances or bleeding ulcers common with higher doses.

Possible side effects include:

  • Indigestion
  • Peptic ulcers
  • Increased bleeding tendency

Over-the-Counter Pain Medications

A variety of nonprescription pain medications may be helpful for in relieving the pain of claudication.

When to Contact Your Doctor

  • Worsening symptoms
  • Medication side effects
  • Foot wounds that do not heal
  • Foot infections

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your doctor.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your doctor.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.