There are a number of vasoactive drugs for intermittent claudication, with evidence that these can increase walking distance in those with PAD.13 The NICE technology appraisal
(TA 223) on “Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of IC in people
with PAD”13 recommended naftidrofuryl oxalate as the preferred treatment. However, it is still unclear how effective
this is when compared to other treatments such as exercise
and angioplasty when patients are suitable for more than one
option. Also, there is no evidence as to whether there is an
identifiable subgroup of people with intermittent claudication that are likely to benefit from drug therapy. It is recommended that clinicians consider naftidrofuryl oxalate for
treating people with intermittent claudication, starting with
the least costly preparation, only when supervised exercise
has been unsatisfactory and the patient prefers not to be
referred for endovascular intervention or surgery. Patients
taking this medication should be reviewed after 3–6 months,
and therapy discontinued if there has been no symptomatic
benefit.