Carl R. Darnall Army Medical Center - Health Library

Medications for Peripheral Artery Disease (PAD)

Here are some facts about medicines that can help treat PAD. Only the most general side effects are listed. Ask your doctor if you need to take any special steps. Use each of these drugs the way your doctor tells you to. Or, follow the fact sheet that come with them. If you have questions, call your doctor.

Medicines can help treat PAD. There are two types:

  • Ones that help your blood flow through narrowed arteries
  • Ones that thin the blood so that it does not clot as easily

Prescription Medications

Pentoxifylline

Antiplatelet agents

  • Clopidogrel
  • Ticlopidine
  • Dipyridamole
  • Cilostazol

Clot-busting drugs (thrombolytic drugs)

  • Recombinant tissue plasminogen activator (rt-PA, alteplase)

Anticoagulants

  • Warfarin
  • Heparin

Over the Counter Medications

Aspirin

Prescription Medications

 

Pentoxifylline

Pentoxifylline helps blood flow by lowering its thickness and making red blood cells move more easily.

Problems you might have are:

  • Stomach upset
  • Nausea
  • Lightheadedness
 

Antiplatelet Agents

Common names are:

  • Clopidogrel
  • Ticlopidine
  • Dipyridamole
  • Cilostazol

Cilostazol is the only antiplatelet agent labeled to treat intermittent claudication. People who use it have been able to walk for longer periods of time and distance. It should not be taken if you have heart failure.

Problems you might have are:

  • Headache
  • Runny nose, sore throat
  • Bowel changes
  • Bleeding
 

Clot-busting Drugs (Thrombolytic Drugs)

Common name: Recombinant tissue plasminogen activator (rt-PA, Alteplase)

Given by IV, this drug is only given to people in the hospital. These drugs may be used if you get acute limb ischemia. This is a serious problem from PAD. It causes blood flow into a limb to lower quickly.

None of these drugs are FDA approved for treating peripheral vascular occlusion. These drugs break down the chemicals that hold blood clots together. Thrombolysis must be safely controlled.

Problems you might have are:

  • Bleeding, such as in sites where you have had surgery or have stomach ulcers
  • Allergic reactions
  • Heart and lung events
 

Anticoagulants

Common names:

  • Heparin
  • Warfarin

These drugs may be used if you get acute limb ischemia. This is a problem from PAD. This is a serious problem from PAD. It causes blood flow into a limb to lower quickly. If this happens, the doctor may inject you with heparin in the hospital. Once at home, an oral version, such as warfarin, may be used.

These drugs work right away to stop blood from clotting. They do not break down a clot after it has formed. If you are at high risk of a repeat clot, these drugs may be needed.

Problems you might have are:

  • Bleeding
  • Allergic reactions
  • Too few platelets

Over the Counter Medications

Aspirin

Aspirin is often used for problems with blood flow due to its safety, low cost, and the way it can reduce heart attacks and other occlusive vascular diseases. Lower doses are less likely to cause stomach problems or bleeding ulcers that are common with higher doses.

Possible side effects are:

  • Indigestion
  • Peptic ulcers
  • Bleeding

When to Contact Your Doctor

  • New or worsening symptoms
  • Drug side effects
  • Foot wounds that do not heal

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take your medicine as advised. Do not change the amount or schedule.
  • Ask what side effects could happen. Tell them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicines can be harmful when mixed. Talk to your doctor or pharmacist if you are taking more than one, including over the counter products and supplements.
  • Plan ahead for refills.
REFERENCES:

American Family Physician. Peripheral vascular disease: diagnosis and treatment. Am Fam Physician. 2006;73(11):1971-1976.

Hills AJ, Shalhoub J, et al. Peripheral arterial disease. Br J Hosp Med (Lond). 2009;70(10):560-565.

Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities. Updated August 23, 2018. Accessed August 29, 2018.

Prevention and treatment of PAD. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/PeripheralArteryDisease/Prevention-and-Treatment-of-PAD_UCM_301308_Article.jsp. Updated October 31, 2016. Accessed August 30, 2018.

11/18/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities: Rooke TW, Hirsch AT, Misra S, et al. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124(18):2020-2045.

Last reviewed June 2018 by EBSCO Medical Review BoardDaniel A. Ostrovsky, MD  Last Updated: 8/29/2018