Buflomedil hydrochloride is a vasoactive
drug with a variety of pharmacodynamic properties. Importantly, it seems to improve nutritional blood flow in ischaemic tissue of patients with peripheral and/or cerebral
vascular disease by a combination of pharmacological effects: inhibition of alpha-
adrenoceptors, inhibition of platelet aggregation, improved erythrocyte deformability, nonspecific and weak
calcium antagonistic effects, and
oxygen sparing activity. Therapeutic trials with
buflomedil in patients with
peripheral vascular diseases have shown that it increases walking distances in those with
intermittent claudication and heals trophic lesions and reduces rest
pain in many patients with more severe vasculopathies. In open clinical trials a good to very good clinical response was achieved in 57 to 87% of those treated. In comparative studies
buflomedil 600 mg/day orally was shown to be significantly superior to placebo and comparable in efficacy to
pentoxifylline (
oxpentifylline) and
naftidrofuryl. In patients with symptoms presumed to be due to
cerebrovascular insufficiencies and elderly patients with
senile dementia,
buflomedil 450 to 600 mg/day alleviated symptoms associated with impairment of cognitive and psychometric function and was significantly superior to placebo and slightly more effective than drugs such as
cinnarizine,
flunarizine and
co-dergocrine mesylate. Overall,
buflomedil at dosages of up to 600 mg/day has been very well tolerated and discontinuation of
therapy has rarely been necessary. Thus,
buflomedil would seem to be a useful adjunct to
conservative treatment in patients with mild-to-moderate
peripheral vascular disease and/or
cerebrovascular insufficiency, and well worth a try in patients with more severe peripheral disease unable to undergo surgery. However, a few well-designed long term studies are needed to fully define its overall place in
therapy.