I didn't say to toss it out :) . I was noticing it's not so efficient, and wondered if its efficacy is due to combination with other therapy.
In the articles Gaby gives, it appears that in jaw osteonecrosis it has been combined to vit E.
In the other article (review on vascular health), the authors conclude " Larger studies are clearly indicated to evaluate pentoxifylline as an
adjunct to current proven therapies."
In tinnitus, it's used also in combination:
Multimodal therapy for chronic tinnitus. https://www.ncbi.nlm.nih.gov/pubmed/18616089
Abstract
From 2001 to 2006, we performed a retrospective study of patients suffering from chronic unilateral or bilateral tinnitus that was previously ineffectively treated by oral drugs [betahistine (Betaserc), extract of Ginkgo biloba (EGb 761), tanakan (Tebokan), and cinnarizine-dimenhydrinate (Arlevert), singly or in combination]. We divided 150 tinnitus patients (80 men, 70 women) into seven treatment groups. Treatments consisted of application of intravenous pentoxifylline, lidocaine, or vinpocetine (Cavinton) and combination of these agents with physiotherapy and soft laser. Mean duration (+/- standard deviation) of tinnitus in these patients was 7.4 +/- 6.0 years; their mean age was 55.6 +/- 12.5 years. The aim of our study was to compare treatment modalities and define their effectiveness for tinnitus relief. The most effective treatment was defined as a combination of Cavinton and physiotherapy. We evaluated pure lidocaine infusion therapy as ineffective. None of the treatment modalities had an objective correlate of improvement, though improvement was reported by a visual analog scale.
Human body is so complex, and drugs can give an antagonist effect. Here is a case of musical tinitus triggered by pento:
Musical hallucinations: perpetual music. https://www.ncbi.nlm.nih.gov/pubmed/24570359
Musical hallucinations are a kind of auditory hallucination that are prevalent among the non-psychiatric population, but which have rarely been reported in the neurological literature. They occur most frequently in the elderly, in females and when there is a loss of hearing, but their pathophysiology has still to be unravelled.
We report here six cases (five females and one male) of musical hallucinations diagnosed in a general neurology clinic over a time-span of five years. In five cases there was also concurrent hypoacusis, to a greater or lesser extent, and one had been triggered by pentoxifylline. In most instances, the musical content of the hallucinations had its origins in music experienced in childhood and early youth. In the cases submitted to pharmacological treatment, the response was poor. Yet, after explaining to the patients that the condition was benign and had no connection with a psychotic pathology, the degree of acceptance of the symptoms was good.
Musical hallucinations are a little-known pathology lying on the borderline between neurology, otorhinolaryngology and psychiatry which are often wrongly linked to mental disease. It is essential to explain to patients and relatives that these symptoms are not necessarily of a psychiatric nature, and to be aware of the potential capacity of some commonly used drugs to generate them.
Gaby, when I read your articles, I think "wow, what a wonderful drug". Nonetheless, in practice, when I see patients treated with pento or other vasodilatators, I see disapointed patients! I also saw some patients who had a crisis of angor or a cerebral stroke while they were under pento (or same family like trimetazidine) for may months or years.
It reminds me of methylen blue; on paper it's a wonderfull drug, but in practice those who tried it didn't notice particular effect.
Now, regarding your articles, I don't deny its usefullness; and yes we can wonder why removing it particularly, whereas other non-usefull drugs are still on the market.
Anyways, thank you for your research of articles, I didn't know its indication as painkiller.
