pentoxifylline + ursodeoxycholic acid + enoxaparin

A fixed-regimen, multi-drug combination of the small molecules pentoxifylline, ursodeoxycholic acid, and the low–molecular-weight heparin enoxaparin investigated to prevent or mitigate focal radiation-induced liver injury after high-dose-rate interstitial brachytherapy for liver metastases. Pentoxifylline is a nonselective phosphodiesterase inhibitor that improves microcirculation and has anti‑inflammatory effects; ursodeoxycholic acid is a hydrophilic bile acid with cytoprotective and anti‑apoptotic effects in hepatocytes; enoxaparin is an anticoagulant that potentiates antithrombin III to inhibit factor Xa and, to a lesser extent, thrombin. In a prospective randomized clinical study, this regimen given for 8 weeks reduced the extent and incidence of focal radiation-induced liver injury at 6 weeks post-therapy versus control, increasing the minimal hepatic threshold dose and lowering MRI evidence of injury; effects were not sustained at 12 weeks after cessation. A separate randomized study of pentoxifylline plus ursodeoxycholic acid without enoxaparin did not support benefit for liver toxicity reduction, highlighting the exploratory status of the triple regimen.

Other names

PTX + UDCA + LMWH