Tag Archives: pentox

Should I continue with pentoxifylline as a Peyronies treatment?

Posted on by Dr.Herazy

Hi Dr. Herazy,

I have been told by two urologists that I have Peyronie and told to come back in 4 or 6 months. I originally felt a tighter than usual erection and latter felt a lump inside my penis. I can feel this with my thumb and another finger, like a small ball inside the shaft close to the base. I am not sure how long I have has this for. I am not sure for how long a have had the curve upwards. It’s not big and I have asked my wife and she is not sure either. Looking closer I can feel where the bent is. I have had no major trauma etc.

I don’t have pain on erections but have been feeling some itchiness type pain when flaccid. And if I have been sitting for long time, I have felt really uncomfortable tightness beginning from under my scrotum to the top of the base of my penis. I get the sense that it’s where I felt the lump.

I have read that TRENTAL/PENTOX/OXPENTIFYLLINE has helped some people in combination with CoQ10 and have got a script from my GP.  I took a test run today of TRENTAL 400 to check for side effects — none so far.

Should I continue with this?

 

Greetings,

I cannot comment whether you should take pentoxifylline (pentox) or not.  That is a decision you must make for yourself in consideration with the advice offered by your treating doctor.   Ultimately you have to feel confident with your treatment and know that it is right for you, and not just simply do what you are told to do.

To give you some perspective, you might want to consider reading Pentoxifylline, niacin and Peyronie’s disease and Pentoxifylline and Peyronie’s disease treatment.

It is good that you have not experienced any side effects to pentoxifylline, but the real question is if it will help your Peyronie’s disease or not. 

I suggest that you consider using Alternative Medicine in the way that is described on the PDI website.  Let me know if you have any questions in this regard.  TRH

Pentoxifylline, Niacin and Peyronie’s Disease

Posted on by Dr.Herazy

Pentoxifylline is not an approved Peyronie’s disease drug

There are several things I find interesting in a question and answer about Peyronie’s disease and Pentoxifylline (Pentox) I discovered online recently.  It appears on the Peyronie’s forum of a medical doctor who is well known as a Peyronie’s disease expert.  I will not use the doctor’s name since it does not serve a useful purpose to mention his name.

Here is the question, followed by the doctor’s answer:

Question:  Can Pentoxifylline help with increasing blood flow when a man has PD?  Also is Niacin also an alternative that might achieve any results?

Answer:   Pentoxifylline has been shown in animal studies to potentially reduce the development of the Peyronie’s scar when the animals consumed the Pentox in their drinking water from the time that the Peyronie’s process is triggered.  Pentoxifylline is indicated to enhance blood flow to the lower extremities in patients with peripheral vascular disease likely because it has a mild non-specific vasodilating effect.  Therefore, it is possible that it can increase blood flow in the man with PD.  As to whether this will improve erections or has anything to do with preventing progression of already established PD is unknown.  Niacin, to my knowledge, has not been studied as a treatment for Peyronie’s disease.

Pentox preferred simply because it is a drug

Point # 1.  The doctor responds that the use of Pentoxifylline is used to treat Peyronie’s disease because it has the ability to enhance blood flow to the lower extremities in patients with peripheral vascular disease likely because of its mild non-specific vasodilating effect.

My response:  Here the doctor is saying that Pentoxifylline is used in Peyronie’s disease because it improves blood flow in people who have peripheral vascular disease.  Anyone who has studied this subject knows that Peyronie’s disease is not a vascular or blood vessel disease, so it is difficult to understand from this answer the connection between the two conditions. This reason he gives for using Pentox for treatment of PD is not supported by what we know about this condition.

Point #2.  The doctor states that Pentoxifylline is used in Peyronie’s disease (of the penis) because it improves blood flow in the periphery of the body, meaning arms and legs.

My response:  These are two different areas of the body. This part of the answer suggests that Pentox has not been tested or shown to actually improve the blood flow to the penis, only the upper and lower extremities.  This reason he gives for using Pentoxifylline for treatment of PD is not supported by what we know about this condition.

Point #3.  The doctor attempts to tie his two points together and then carefully speculates that “it is possible that it can increase blood flow in the man with PD.”

My response:  What the doctor is saying is that using Pentox for Peyronies treatment might possibly work since it works for other conditions that are only remotely related. This kind of speculative use of a drug is common, and would not be objectionable except for the fact that Pentoxifylline is known to have side effects that can affect the cardiovascular, immune, digestive, respiratory, visual and nervous systems. That is a risk taken by a patient for use of a drug that might only possibly help an unrelated condition.  I doubt many patients know that they are exposing themselves by taking drugs that are not known to help the condition they have.

Point #4.  The doctor reports that it is unknown if Pentoxifylline will improve erections or has anything to do with preventing progression of an existing case of Peyronie’s disease.

My response:   Saying that it is unknown if Pentox will improve erections suggests that it does not influence blood flow to the penis. Yet, improving penile blood flow is one of the reasons given by this doctor to justify using it for Peyronie’s disease.   Since I have never heard of anyone taking any medication for prevention of Peyronie’s disease, the doctor also says that Pentoxifylline will not alter the progression of a case of PD once it has started.  This sounds to me that it would not help Peyronie’s disease.

Point #5.  The doctor reports that to his knowledge niacin (a member of the B vitamin family) has never been studied as a possible treatment for Peyronie’s disease.

My response:  Niacin is well known to those who take vitamins for the “niacin flush” that it causes.  Niacin causes an increased blood flow throughout the body, experienced as heat, redness and itching that occurs after taking a few hundred milligram dose.

So we have the doctor reporting that Pentox (with side effects) is used to treat Peyronie’s disease because it has a “mild non-specific vasodilating effect,” yet niacin (with no side effects) which also has a mild to moderate non-specific vasodilating effect has never been studied as a Peyronie’s treatment.

I think this is a classic example of the drug industry ignoring potential non-drug therapies simply because they lack profitability.  This is a point to remember when you are told that no nutritional therapy has been shown to help PD.   This is only true because these companies refuse to do the testing to prove they might have merit.

Point #6.   The doctor uses  only one brief  sentence to discuss niacin, and 90% of his reply to discuss a drug that does the same thing as niacin can do and do it without side effects.  In his short sentence about niacin he only says that it has not been studied as a Peyronie’s treatment.  Period.  As a scientist, as a physician interested in advancing the body of thought about Peyronie’s treatment, wouldn’t you think the doctor would be more interested in something like niacin?  Instead, he merely brushes the idea of niacin use for PD aside.  This is so typical of the attitude of organized medicine about treatment of Peyronie’s disease.

Point #7.  The man who asked a reasonable and intelligent question about niacin was not given an actual answer about niacin.    He was only given a reply that promoted the use of a drug that has side effects and not known to be effective against Peyronie’s disease.   And you wonder why men get frustrated with the lack of help and useful information about Peyronies treatment.

Pentoxifylline and Peyronie’s Disease Treatment

Posted on by Dr.Herazy

Pentox for Peyronie’s treatment is an off-label use

Every now and then I get an email asking for my opinion about using Pentox (Pentoxifylline) for Peyronie’s disease treatment.  Over time I have developed a few ideas about this controversial drug that is gaining some popularity as an off-label Peyronie’s treatment.

Those MDs who prescribe Pentox are still trying to figure out the best way to use it, not only for PD but for many other conditions.  While the primary use for Pentoxifylline is based on its ability to increase peripheral blood circulation, hence it is used to treat senile dementia and intermittent claudication, Pentox is gaining acceptance with the medical community for Peyronie’s treatment.

Some MDs who have learned the hard way that PDE5 drugs (Viagra, Cialis, Levitra) are not at all a safe or effective Peyronie’s treatment have instead begun to prescribe Pentox to increase blood flow in Peyronies.   But to have that make any sense at all you have to believe that PD is caused by reduced blood flow in the first place, or that merely increasing the blood flow will somehow help PD.  I can totally agree with that thinking if you have evidence that your penis suffers from reduced blood flow (it is cold and blue).  But if your penis is not cold and blue and bent, then you probably will not benefit from Pentox in the way that most people think.

It is my opinion that when Pentox is said to help men with PD it is because as the blood flow is increased to the periphery, it also brings in an increased flow of nutrients to assist the healing process.  Further, when Pentox helps a case of PD it is because of the totally secondary benefit of increasing the body’s ability to heal and repair the PD plaque when there are more nutrients in an area of the body.   It is a small point, perhaps, but a vitally important point to understand that it all comes down to the body healing the PD scar – not the Pentox having some curative ability by itself.   If Pentoxifylline can increase general circulation more safely than Viagra, Cialis, and Levitra, then great I am all for that.  But you have to consider that if you do not have a circulatory problem in the first place, then why take any of these drugs at all?

If the benefit of Pentox is to bring more nutrients into the tissues, to assist healing and repair of the PD plaque or scar, that is wonderful.  If it is beneficial to bring more nutrients into the tissue, would it not be a more logical and effective Peyronie’s treatment to intentionally and intelligently supply a wide variety of nutrients at a higher than average dosage to the body to assist the healing process?  After all, that is what PDI has been doing since 2002 and it works in a great percentage of cases when it is done correctly.

Since extremely few men actually have any evidence of a circulatory problem in the pelvis, taking Pentox or even Viagra, Cialis, and Levitra, will not make a difference because that is not the problem that is going on with PD.   If the problem is that you did not heal your tunica albuginea injury because of poor nutrient availability then I suggest it would do you a lot of good to increase the nutrients directly, not indirectly by playing with the circulatory system when there is no circulatory problem.

You notice that I do not say, “Do not take Pentox,” I only say it is new so use caution.  I also say that when Pentoxifylline helps it probably does so only because it helps the body work better by increasing available nutrients, not because it specifically increases blood flow.  If you want to help your pelvic blood flow:

1.    Wear boxer shorts

2.    Uncross your legs when you sit

3.    Do some Kegel exercises

4.    Put a moist hot pack on your privates when you watch TV

Most MDs are taking the attitude that while they do not know if Pentox helps PD, or why it helps when it appears to help PD, at least they currently have no evidence that it makes PD worse – so what the hell, take it and let’s see what it does for you.  This is how many medical patients get hurt in the long run with such a cavalier attitude about drugs.

I say better to take an Alternative Medicine approach to your problem to help your body heal and repair the Peyronie’s pathology naturally.

Pentoxifylline and Peyronie’s Disease

Posted on by Dr.Herazy

Pentox not researched Peyronie’s disease treatment

Pentoxifylline (often called simply, Pentox) is a drug that is sometimes used in medical Peyronie’s disease treatment.  The exact mechanism by which Pentox affects the Peyronie’s plaque is not at all understood.  But then, its use for PD is called off-label – meaning experimentally and without scientific basis since the drug was not intended or designed to be used in this way.  This is similar to the way that Viagra, Cialis and Levitra are prescribed for PD, even though this is also an irregular use of these drugs; Verapamil is used in a similar off-label manner.

Pentoxifylline is not a vasodilator; it affects the body by changing the shape of red blood cells while in the blood vessels by a mechanism that is not completely understood.  This change allows for improved flow into the smaller arteries and even capillaries of the body. For this reason it is commonly used for treatment of circulation problems in the arms and legs.  While being taken, the effects are experienced as though Pentox is a vasodilator but it is not.

Pentoxifylline is one of those drugs that have multiple off-line uses as determined by any adventurous doctor who is willing to experiment with his/her patients. This is good and bad at the same time.  Apparently pentoxifylline does so many things in the body that it can and is applied to many conditions – this is good, I suppose.  But because it does so many things in so many areas and systems of the body that Pentox is more likely to cause widespread and surprising side effects and new problems that new health problems can develop in those who experiment with it – this is bad.    It has been used in humans for a wide variety of inflammatory and fibrotic conditions; hence, it has been also used for Peyronie’s disease at times.   When it does seem to help PD, the mechanism is not understood, but could be related to blocking of the transforming growth factor (TGF)-1-mediated pathway of inflammation, thus prevents deposition of collagen type 1.

It comes as a tablet that is specially coated to prevent stomach lining irritation.  For this reason do not break, crush, or chew the tablets; swallow dosage whole. Do not stop taking pentoxifylline suddenly. It may take 8-12 weeks for any beneficial effects of pentoxifylline to be noted.

This drug is so new that there have been very few – maybe only one – studies of pentoxifylline for any use.  It has yet to be determined how much and how reliably pentoxifylline reduces plaque formation in later term or well developed Peyronie's disease.

Before taking this medication, let your doctor know if you have an ulcer of the stomach or duodenum, liver disease, any type of bleeding disorder or any type of surgery.

Lastly, because pentoxifylline increases the movement of blood into and out of all areas of the body, it increases how the body responds to some drug functions and reactions.  For this reason, if you are taking another medication along with Pentox you might notice that the other drug will begin to affect you stronger or differently than before.  Thus it might be necessary to adjust the dosage of these other drugs while you are taking pentoxifylline.

I have run across many men who were put on this drug and had no improvement of their PD, and experienced multiple side effects strong and bizarre enough that they had to stop usage – and this made their problem even worse.  These Pentox side effects include loss of appetite, nausea, constipation, headache, dizziness, anxiety or blurred vision may occur at first as your body adjusts to the medication.  More significant are the other side effects of chest pain, mental confusion, gastric irritation, difficulty breathing, or severe rashes that should prompt immediate attention of the prescribing doctor.  Also, pentoxifylline can be difficult to reduce once you are on it since rapid reduction can worsen any of the above side effects.

For information about the natural Alternative Medicine treatment of Peyronie’s disease please visit the Peyronies Disease Institute website.