Comprehensive medication guide to Pentoxifylline XR including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic pentoxifylline on most commercial plans (Tier 1–2); $0–$15 on most Medicare Part D plans. Prior authorization is rarely required.
Estimated Cash Pricing
$30–$80 retail for a 30-day supply (90 tablets) without insurance; as low as $15–$25 with GoodRx or SingleCare coupons at participating pharmacies.
Medfinder Findability Score
78/100
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Pentoxifylline XR (extended-release pentoxifylline) is a prescription medication used primarily to reduce leg pain and cramping caused by insufficient blood flow during walking — a condition called intermittent claudication due to peripheral artery disease (PAD). It belongs to a drug class known as hemorheologic agents: medications that improve blood flow by altering the physical properties of blood.
FDA-approved since 1984, pentoxifylline was originally sold under the brand name Trental by Sanofi-Aventis and is also known by the brand Pentoxil (Upsher-Smith). Today it is widely available as a generic 400mg extended-release oral tablet. It is also used off-label for Peyronie's disease, chronic venous leg ulcers, osteoradionecrosis of the jaw, and alcoholic hepatitis.
The standard dosage is 400mg taken orally three times daily with meals. The medication must be swallowed whole — the extended-release tablet formulation should never be crushed or chewed. It may take 2–4 weeks for symptoms to improve, with maximum benefit typically seen at 8 weeks.
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Pentoxifylline XR works through multiple complementary mechanisms to improve blood flow through narrowed arteries. Rather than widening blood vessels directly, it changes the physical properties of blood itself — making it easier to flow through constricted passages.
As a competitive nonselective phosphodiesterase (PDE) inhibitor, pentoxifylline blocks the enzyme PDE, causing cyclic AMP (cAMP) to accumulate inside red blood cells and platelets. In red blood cells, elevated cAMP increases flexibility (deformability), allowing them to squeeze through narrowed capillaries more easily. In platelets, high cAMP inhibits aggregation, reducing the tendency for blood clots to form. Pentoxifylline also stimulates fibrinolysis — breaking down fibrinogen to reduce blood viscosity — and inhibits thromboxane synthesis while increasing prostacyclin synthesis, both of which further reduce platelet clumping.
Additionally, pentoxifylline inhibits TNF-alpha and leukotriene production, giving it anti-inflammatory properties that may explain its off-label efficacy in conditions like Peyronie's disease and osteoradionecrosis of the jaw. The extended-release formulation releases medication gradually over several hours, avoiding sharp peaks and troughs in blood levels and improving tolerability.
400 mg — Extended-release oral tablet
Standard dose: one tablet three times daily with meals. Reduce to twice daily if GI or CNS side effects occur. Reduce to once daily for severe renal impairment (CrCl <30 mL/min).
Pentoxifylline XR is not currently on the FDA's official drug shortage list as of 2026. However, patients regularly encounter pharmacy-level out-of-stock situations due to the medication's relatively low demand at individual pharmacy locations. Because multiple generic manufacturers produce pentoxifylline (including Sun Pharma, Teva, Aurobindo, and Zydus), but individual pharmacies typically source from only one supplier, a distributor delay can temporarily affect availability at that specific location.
Independent pharmacies and mail-order pharmacies tend to have more consistent availability than chain retail locations for lower-volume drugs like Pentoxifylline XR. Patients experiencing availability issues should check multiple pharmacies, request a special order (typically 1–2 business days), consider 90-day mail-order fills, or ask for a partial fill to bridge the gap.
Need help finding Pentoxifylline XR in stock near you? medfinder contacts pharmacies on your behalf, checks which ones have it in stock, and texts you the results — saving you hours of calling around.
Pentoxifylline XR is not a controlled substance and has no DEA scheduling. This means any licensed prescriber — in any specialty — can write a prescription without special authorization or registration requirements. There are no quantity limits imposed by law, and 90-day supplies can be prescribed for stable patients.
Prescribers who commonly write Pentoxifylline XR include:
Vascular surgeons and vascular medicine specialists (primary managers of PAD)
Cardiologists (managing PAD and cardiovascular comorbidities)
Primary care physicians and internists (most common prescribers for mild-moderate PAD)
Geriatricians (PAD is prevalent in older adults)
Nurse practitioners (NPs) and physician assistants (PAs)
Urologists (for off-label Peyronie's disease use)
Oral and maxillofacial surgeons (for off-label osteoradionecrosis protocol)
Because Pentoxifylline XR is not a controlled substance, telehealth providers can prescribe it without any in-person visit requirement or special DEA registration. This makes it highly accessible for patients with limited mobility, rural patients, or those seeking faster prescription access through telehealth platforms.
No. Pentoxifylline XR is not a controlled substance and has no DEA schedule. It does not have abuse potential and does not require special DEA registration to prescribe. Any licensed healthcare provider — including primary care physicians, nurse practitioners, physician assistants, and telehealth providers — can prescribe it without additional requirements.
Because it is not a controlled substance, there are no restrictions on prescribing 90-day supplies, early refills, or mail-order dispensing. Prescriptions can be sent electronically, by fax, or by phone to any pharmacy. Patients can also transfer their prescription to any pharmacy without the restrictions that apply to controlled substances. This makes Pentoxifylline XR particularly well-suited for telehealth prescribing and mail-order delivery for chronic disease management.
The most frequently reported side effects of Pentoxifylline XR are digestive and central nervous system-related. These typically appear within the first few weeks and often improve over time, especially when the medication is taken with food:
Nausea (most common)
Vomiting
Stomach discomfort, bloating, and indigestion
Dizziness
Flushing (warmth, redness, or tingling in the face)
Belching and headache
Serious side effects (rare — seek immediate medical attention):
Anaphylaxis / severe allergic reaction (hives, difficulty breathing, facial swelling) — stop medication and call 911
Unusual bleeding or bruising (blood in urine/stool, prolonged bleeding) — especially with concurrent anticoagulants
Chest pain, arrhythmia, or palpitations
Severe dizziness or fainting
Liver problems (jaundice, dark urine, severe upper abdominal pain)
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Cilostazol (Pletal)
Preferred first-line pharmacological agent per AHA/ACC for intermittent claudication. More effective for walking distance than pentoxifylline. Contraindicated in heart failure.
Clopidogrel (Plavix)
Antiplatelet agent for cardiovascular risk reduction in PAD. Widely available in generic form at low cost.
Aspirin (low-dose)
Standard antiplatelet adjunct in PAD for cardiovascular protection. Often used alongside pentoxifylline.
Supervised Exercise Therapy
Non-pharmacological first-line treatment for intermittent claudication. Multiple guidelines consider it the most effective intervention for improving walking distance and quality of life.
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Warfarin (Coumadin)
majorPentoxifylline enhances warfarin's anticoagulant effects, increasing INR and bleeding risk. Monitor INR more frequently when starting or adjusting pentoxifylline.
Ketorolac (Toradol)
majorConcurrent use significantly increases bleeding risk. This combination should be avoided.
Clopidogrel (Plavix)
moderateBoth drugs inhibit platelet aggregation. Combined use increases bleeding risk — monitor for signs of unusual bleeding.
NSAIDs (ibuprofen, naproxen)
moderateCombined antiplatelet effects increase GI and systemic bleeding risk. Use acetaminophen for pain relief when possible.
Theophylline
moderatePentoxifylline may increase theophylline blood levels. Monitor theophylline levels — toxicity can cause arrhythmias and seizures.
Antihypertensives (ACE inhibitors, beta-blockers)
moderateAdditive blood pressure lowering effect. Monitor for dizziness or hypotension when starting pentoxifylline.
Insulin and oral antidiabetics
moderateAdditive blood glucose-lowering effect possible. Diabetic patients should monitor blood sugar more closely.
Fluoxetine / Fluvoxamine (SSRIs)
moderateIncreased anticoagulation risk. Monitor for signs of bleeding.
Pentoxifylline XR is a well-established, affordable medication for patients with intermittent claudication and peripheral artery disease. While newer evidence suggests cilostazol may be more effective for improving walking distance, pentoxifylline remains an important option — particularly for patients who cannot tolerate cilostazol due to heart failure, and for off-label applications in conditions like Peyronie's disease and osteoradionecrosis.
The medication is not a controlled substance, is available in generic form for $15–$25 per month with a discount coupon, and can be prescribed by virtually any licensed healthcare provider including telehealth practitioners. For stable patients, a 90-day mail-order supply is both cost-effective and minimizes the localized pharmacy stocking gaps that some patients encounter.
If you're having trouble finding Pentoxifylline XR at your local pharmacy, medfinder can help. Provide your medication name, dosage, and ZIP code, and medfinder contacts pharmacies near you to find which ones have it in stock. Results come back by text — no hold music, no wasted trips.
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