Cilostazol
Vasotherapeutic · Antiplatelet-vasodilator
Indications
Improvement of maximal and pain-free walking distances in patients with intermittent claudication who do not have rest pain or evidence of peripheral tissue necrosis.
Dosage
Adults: 100 mg twice daily 30 min before or 2 hr after breakfast and evening meal. Dose 50 mg twice daily are used with certain drugs. Children: Not recommended.
Adverse Effects
Headache, diarrhoea, abnormal stools, ecchymosis, oedema, dizziness, palpitation, tachycardia, angina, arrhythmia, ventricular extrasystole, rhinitis, GI upset, anorexia, pharyngitis, rash, pruritus, chest pain, asthaenia. Reports of blood dyscrasias.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Severe renal impairment, moderate to severe hepatic impairment, congestive heart failure, predisposition to bleeding, history of ventricular tachycardia, multifocal ventricular ectopics or severe tachycardia. QTc prolongation, unstable angina, recent MI or coronary intervention. Precautions: Advise patients to report any episodes of bleeding or bruising. Atrial or ventricular ectopy, atrial fibrillation or flutter, diabetes. Stable coronary disease, monitor closely. Discontinue if evidence of blood dyscrasias. Withdraw 5 days before elective surgery.
Interactions
Cimetidine, diltiazem, erythromycin, clarithromycin, ketoconazole, lansoprazole, omeprazole, protease inhibitors, cisapride, midazolam, nifedipine, verapamil, other inhibitors or substrates of CYP3A4 or 2C19. Highly protein bound drugs, hypotensive agents, aspirin, antiplatelets, clopidogrel, anticoagulants, vasodilators, statins, pimozide, ergot derivatives, inducers of CYP3A4 or 2C19 (e.g., anticonvulsants, rifampicin, St John's wort).
Advice to Patient
Take 30 minutes before meals or 2 hours after meals. Contact prescriber if there are chest pain, palpitations, unusual heartbeat, swelling of extremities, unusual bleeding, unresolved GI upset or pain, muscle cramps or unusual cough. Avoid grapefruit juice during therapy. Avoid smoking during therapy. Change position slowly. Medicine effectiveness is based on ability to walk increased distances. Medicine effects will not appear until 2 to 4 weeks after therapy starts and full effects may take upto 12 weeks.
Pharmacokinetics
Onset of action: Effect on walking distance: 2-4 wks; may require up to 12 wks. Metabolism: Hepatic. Half-life elimination: Approx. 11-13 hrs. Excretion: Urine (74%). Faeces (20%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.