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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:
Clot-busting drugs (thrombolytic drugs)
Common brand name: Trental
Pentoxifylline improves blood flow by lowering its viscosity (thickness) and making red blood cells more flexible.
Possible side effects include:
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:
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:
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:
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:
A variety of nonprescription pain medications may be helpful for in relieving the pain of claudication.
Whenever you are taking a prescription medication, take the following precautions:
References:
Braunwald E, Fauci AS, eds. Harrison's Principles of Internal Medicine . 16th ed. McGraw-Hill Professional; 2004.
Drug Facts and Comparisons . St. Louis, MO: Facts and Comparisons; 2001.
Textbook of Clinical Neurology . 2nd ed. W.B. Saunders; 2003.
Last reviewed July 2008 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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