What Is Pentoxifylline XR? Uses, Dosage, and What You Need to Know in 2026

Pentoxifylline XR is a prescription medication used primarily to reduce leg pain and cramping caused by blocked blood flow in the arteries — a condition called intermittent claudication. This guide covers what the drug is, what it treats, how to take it correctly, what to expect, and key safety information for 2026.

What Is Pentoxifylline XR?

Pentoxifylline XR (extended-release pentoxifylline) is a xanthine derivative that belongs to the class of drugs known as hemorheologic agents — medications that improve blood flow by changing the properties of blood itself. It was first approved by the FDA in 1984 under the brand name Trental and is now widely available as a generic medication.

The "XR" (or "ER") in the name stands for extended-release — meaning the tablet is specially designed to release medication slowly over several hours. This reduces peaks and valleys in blood levels and is associated with fewer GI side effects compared to immediate-release formulations. The medication must be swallowed whole — never crushed or chewed.

Brand Names vs. Generic

The original brand name for pentoxifylline was Trental (manufactured by Sanofi-Aventis). Another brand, Pentoxil, was distributed by Upsher-Smith. The medication is also known informally as "Pentoxifylline SR" (sustained-release). Today, most prescriptions are filled with the generic version, which is bioequivalent and significantly less expensive.

What Is Pentoxifylline XR Used For?

FDA-Approved Indication:

Intermittent claudication due to chronic occlusive peripheral artery disease (PAD): Reduces leg pain, cramping, and fatigue during walking or exercise caused by blocked arteries limiting blood flow to the legs.

Off-Label Uses (used by some clinicians, not FDA-approved):

Peyronie's disease (penile fibrosis causing curvature)

Chronic venous leg ulcers (as adjunct to compression, per SIGN guidelines)

Osteoradionecrosis of the jaw and medication-related osteonecrosis (with tocopherol and/or clodronate — the PENTOCLO protocol)

Alcoholic hepatitis (adjunctive treatment)

Diabetic neuropathy (supportive)

Pentoxifylline XR Dosage and How to Take It

The standard adult dose of Pentoxifylline XR is:

400mg orally, three times daily (1,200mg/day total) — taken with meals to reduce GI side effects

Reduced dose: 400mg twice daily (800mg/day total) — if GI or CNS side effects occur at the standard dose

Renal impairment (CrCl <30 mL/min): 400mg once daily

Important administration rules:

Always take with food or milk — food increases absorption and reduces stomach upset

Swallow the tablet whole — do not crush, chew, or break it

Take at consistent times each day — typically with breakfast, lunch, and dinner

It may take 2–4 weeks to notice improvement; allow up to 8 weeks for full benefit

Who Should NOT Take Pentoxifylline XR?

Pentoxifylline XR should not be taken if you:

Have recently had a bleeding event in the brain (cerebral hemorrhage) or retina of the eye

Are allergic to pentoxifylline or other xanthine derivatives (caffeine, theophylline, theobromine)

Have active or recent peptic ulcer disease

Have severe coronary artery disease (at physician's discretion)

Is Pentoxifylline XR a Controlled Substance?

No. Pentoxifylline XR is not a controlled substance and has no DEA schedule. It can be prescribed by any licensed provider (including telehealth providers), filled without special controls, and dispensed in 90-day supplies without restriction.

Having trouble finding Pentoxifylline XR at your pharmacy? medfinder locates pharmacies near you that have it in stock. Also see: How to Save Money on Pentoxifylline XR in 2026