Formulary
Cilostazol: Indications, Dosing, Side Effects and Interactions
Cilostazol clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Cilostazol: Indications, Dosing, Side Effects and Interactions
Cilostazol clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Intermittent claudication in patients without rest pain and no peripheral tissue necrosis**
- **Adult** (By Mouth): 100 mg twice daily, to be taken 30 minutes before food, cilostazol should be initiated by those experienced in the management of intermittent claudication, patients receiving cilostazol should be assessed for improvement after 3 months; consider discontinuation of treatment if there is no clinically relevant improvement in walking distance.
Cautions
Atrial fibrillation; atrial flutter; atrial or ventricular ectopy; diabetes mellitus (higher risk of intraocular bleeding); stable coronary disease; surgery
Contraindications
Active peptic ulcer; congestive heart failure; coronary intervention in previous 6 months; haemorrhagic stroke in previous 6 months; history of severe tachyarrhythmia; myocardial infarction in previous 6 months; poorly controlled hypertension; predisposition to bleeding; proliferative diabetic retinopathy; prolongation of QT interval; unstable angina; ventricular arrhythmia
Side effects
Common or very common Appetite decreased; arrhythmias; diarrhoea; dizziness; gastrointestinal discomfort; gastrointestinal disorders; headache; increased risk of infection; nausea; oedema; palpitations; skin reactions; vomiting Uncommon Anaemia; anxiety; congestive heart failure; cough; dyspnoea; haemorrhage; hyperglycaemia; hypotension; sleep disorders; syncope Rare or very rare Renal impairment; thrombocytosis Frequency not known Agranulocytosis; bone marrow disorders; conjunctivitis; fever; granulocytopenia; hepatic disorders; hot flush; hypertension; intracranial haemorrhage; leucopenia; paresis; severe cutaneous adverse reactions (SCARs); thrombocytopenia; tinnitus; urinary frequency increased
Interactions
**Severe interactions:**
- All healthy subjects in the study had a prolongation of bleeding time on clopidogrel alone and concomitant administration with cilostazol did not result in a significant additional effect on...
**Other interactions (34):**
- Inhibitors of platelet aggregation Cilostazol is a PDE III inhibitor with antiplatelet activity.
- In a clinical study in healthy subjects, cilostazol given 150mg b.i.d.
- Acetylsalicylic Acid (ASA) Short term (4 days) co-administration of ASA with cilostazol suggested a 23-25% increase in inhibition of ADP-induced ex vivo platelet aggregation when compared to ASA...
- There were no apparent trends toward a greater frequency of haemorrhagic adverse effects in patients taking cilostazol and ASA compared to patients taking placebo and equivalent doses of ASA.
- Clopidogrel and other antiplatelet drugs Concomitant administration of cilostazol and clopidogrel did not have any effect on platelet count, prothrombin time (PT) or activated partial thromboplastin...
- Caution is advised when co-administering cilostazol with any drug that inhibits platelet aggregation.
Pregnancy
Avoid-toxicity in animal studies.
Breast feeding
Present in milk in animal studies-manufacturer advises avoid.
Hepatic impairment
Manufacturer advises avoid in moderate-to-severe impairment-no information available.
Renal impairment
Avoid if creatinine clearance less than 25 mL/minute. M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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