Cilostazol

What is Cilostazol?

• Cilostazol (Pletal) is a phosphodiesterase III inhibitor (PDE III inhibitor), used to reduce the symptoms of intermittent claudication.

Cilostazol

What are the uses of this medicine?

• Cilostazol (Pletal) is a prescription medicine used to reduce the symptoms of intermittent claudication and can increase your ability to walk further distances.

How does this medicine work?

• Cilostazol (sye loe' sta zol) acts by semi-selective inhibition of phosphodiesterase III, which causes an increase in intracellular cyclic AMP resulting in arterial vasodilation and inhibition of platelet aggregation.
• Cilostazol is used largely to treat symptoms of intermittent claudication due to peripheral vascular disease where it has been shown to increase pain-free walking distance and improve exercise tolerance.
• Cilostazol has also been evaluated as an antiplatelet agent and is used off-label as a means of prevention of recurrent stroke.

Who Should Not Use this medicine ?

This medicine cannot be used in patients who:

• have heart problems (heart failure)
• are allergic to cilostazol or any of the ingredients in cilostazol.

What drug interactions can this medicine cause?

• Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Be sure to mention any of the following:

• anticoagulants (blood thinners) such as warfarin (Coumadin)
• aspirin
• antifungal medications such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• antiplatelet medications such as clopidogrel (Plavix), prasugrel (Effient), and ticlopidine (Ticlid)
• clarithromycin (Biaxin)
• diltiazem (Cardizem, Dilacor, Tiazac, others)
• erythromycin (E-mycin, Ery-Tab, others); fluoxetine (Prozac)
• fluvoxamine (Luvox)
• nefazadone
• omeprazole (Prilosec)
• sertraline (Zoloft).

Is this medicine FDA approved?

• Cilostazol was approved in the United States in 1999 and is widely used with more than one million prescriptions filled yearly. Current indications are limited to treatment of symptoms of intermittent claudication.

How should this medicine be used?

Recommended dosage:

• The recommended dosage of cilostazol is 100 mg twice daily taken at least half an hour before or two hours after breakfast and dinner.
• Reduce the dose to 50 mg twice daily when co-administered with CYP3A4 inhibitors such as ketoconazole, itraconazole, erythromycin, and diltiazem, or CYP2C19 inhibitors such as ticlopidine, fluconazole, and omeprazole.

• Patients may respond as early as 2 to 4 weeks after the initiation of therapy, but treatment for up to 12 weeks may be needed before a beneficial effect is experienced.
• If symptoms are unimproved after 3 months, discontinue cilostazol.

Administration:

• Cilostazol comes as a tablet to take by mouth.
• Take cilostazol exactly as your doctor tells you to take it.
• Your doctor will tell you how much cilostazol to take and when to take it.
• Your doctor may change your dose if needed.
• Take cilostazol 30 minutes before you eat or 2 hours after you eat.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Tablets: 50 mg and 100 mg

This medicine is available in fallowing brand namesː

• Pletal

What side effects can this medication cause?

The most common side effects of this medicine include:

• headache
• abnormal stools
• diarrhea

Cilostazol may cause serious side effects, including:

• heart problems
• Cilostazol stops a protein called phosphodiesterase III from working.
• anaphylaxis
• angioedema
• thrombocytopenia
• leukopenia

What special precautions should I follow?

• Cilostazol may induce tachycardia, palpitation, tachyarrhythmia or hypotension. Patients with a history of ischemic heart disease may be at risk for exacerbations of angina pectoris or myocardial infarction.
• Cases of thrombocytopenia or leukopenia progressing to agranulocytosis when cilostazol was not immediately discontinued have been reported. Monitor platelets and white blood cell counts periodically.
• Cilostazol inhibits platelet aggregation in a reversible manner. Cilostazol has not been studied in patients with hemostatic disorders or active pathologic bleeding. Avoid use of cilostazol in these patients.
• Cilostazol has not been associated with serum enzyme elevations during therapy or with published instances of clinically apparent liver injury.
• Advise the patient:
• to take cilostazol at least one-half hour before or two hours after food.
• to discuss with their doctor before taking any CYP3A4 or CYP2C19 inhibitors (e.g., omeprazole).
• The beneficial effects of cilostazol on the symptoms of intermittent claudication may not be immediate. Although the patient may experience benefit in 2 to 4 weeks after initiation of therapy, treatment for up to 12 weeks may be required before a beneficial effect is experienced. Discontinue cilostazol if symptoms do not improve after 3 months.
• It is not known if cilostazol passes into your breast milk. You and your doctor should decide if you will take cilostazol or breastfeed. You should not do both.

What to do in case of emergency/overdose?

Symptoms of overdose may include:

• severe headache, diarrhea, hypotension, tachycardia, and possibly cardiac arrhythmias.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• The patient should be carefully observed and given supportive treatment.
• Since cilostazol is highly protein-bound, it is unlikely that it can be efficiently removed by hemodialysis or peritoneal dialysis.

Can this medicine be used in pregnancy?

• Pregnancy Category C.
• There are no adequate and well-controlled studies in pregnant women.
• It is not known if cilostazol will harm your unborn baby.

Can this medicine be used in children?

• The safety and effectiveness of trospium chloride in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

• Active ingredient: cilostazol USP
• Inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, hypromellose, lactose monohydrate, magnesium stearate and microcrystalline cellulose.

Who manufactures and distributes this medicine?

Distr. by:

• West-Ward Pharmaceuticals Corp.
• Eatontown, NJ

What should I know about storage and disposal of this medication?

• Store cilostazol at room temperature between 20˚C to 25˚C (68˚F to 77˚F).

• Dailymed label info on Cilostazol
• FDA Cilostazol

Cilostazol Resources
Latest articles Most recent articles Ongoing trials	Wikipedia

• Dailymed label info on Cilostazol
• FDA Cilostazol

Cilostazol Resources
Latest articles Most recent articles Ongoing trials	Wikipedia