Cilostazol (Oral)

Cilostazol is used in the treatment of leg pain that is caused by the poor flow of blood through the blood vessels.

Overview

Cilostazol is used in the treatment of leg pain that is caused by poor circulation of blood through the blood vessels of the patient. Cilostazol works to improve the flow of blood by preventing the blood from clotting and dilating the blood vessels. Treatment with Cilostazol can allow patients to walk farther without having to rest because of the pain that is caused.

This medication is provided with a doctor's prescription in the form of Pletal tablets. It can take several weeks of treatment before the patient will notice changes and enjoy the benefits of taking this medication.

This medication will be less effective in patients who smoke and smoking will also worsen the medical condition it is treating. Patients using this treatment should avoid tobacco products.

Condition treated

Type of medicine

  • Platelet-aggregation inhibitors

Side effects

In addition to the required effects that are achieved through the use of Cilostazol, other side effects can occur that may require medical attention. While not all of the following side effects may occur, the patient should be alert to their occurrence and respond as described:

You should make immediate contact with your doctor if the following side effects occur:

Occurring more commonly:

  • style="font-weight: 400;">Feverishness
  • Increase in rate of heartbeat
  • Irregularity of heartbeat

Occurring less commonly:

  • Abnormal bleeding
  • Blood filled or black stools with an appearance of tar
  • Faintness
  • Nosebleeds
  • Ongoing nausea, heartburn, or indigestion
  • Severe stomach pains or burning sensation
  • Stiffness of the neck
  • Swelling of the tongue
  • Unexplained bruises or red spots on the skin
  • Vomiting of blood or material with the appearance of coffee grounds

Frequency of incidence not known:

  • Abdominal pain
  • Bleeding easily
  • Bleeding from the gums
  • Blistering or peeling of skin
  • Blood seen in the urine or stools
  • Blurring of vision
  • 400;">Chest pains
  • Chills when warm
  • Clay-like coloration of stools
  • Confusion or disorientation
  • Coughing or hoarseness
  • Coughing up of blood
  • Darkened urine
  • 400;">Diarrhea
  • Difficulty in breathing
  • Drowsiness or sleepiness
  • Feverishness with or without chills
  • General feeling of tiredness
  • General feeling of weakness
  • Inability to speak or communicate
  • Itchiness of the eyes
  • Itchiness of the skin
  • Joint pains
  • Muscle pains
  • Lightened coloration of stools
  • Loosening of the skin
  • Loss of consciousness
  • Loss of hunger
  • Lower back pain or side pain
  • Nausea and/or vomiting
  • Pain or difficulty experienced during urination
  • Pinpoint red spots
  • Rash
  • Redness or irritation of the eyes
  • Red skin lesions, which may have a purple center
  • Seizures or convulsions
  • 400;">Skin rash with or without lesions
  • Slurring of speech
  • Sores or ulcers
  • Stomach pain
  • Stomach pains
  • A sudden and severe headache
  • Sudden or severe weakness experienced in the arm or leg down one side of the body
  • Swelling of the glands
  • Temporary loss of sight
  • Unpleasant and unusual breath odor
  • Unusual bleeding
  • Unusual bruising
  • Unusual tiredness
  • Unusual weakness
  • Weakness of parts of the body
  • White spots on the lips or mouth
  • Yellowing of the eyes
  • Yellowing of the skin

Other side effects can occur that would not usually necessitate the patient seeking medical attention. If, however, these side effects are ongoing or bothersome then you should consult your doctor who may be able to help you to alleviate the side effects.

Occurring more commonly:

  • Back pains
  • 400;">Dizziness
  • Gas build up
  • Headaches
  • Increased coughing
  • Pain or stiffness in the muscles
  • Pounding heartbeat
  • Runniness or stuffiness of the nose
  • Soreness of the throat
  • Swelling of the arms or legs

Occurring less commonly:

  • Bone pains
  • Burning feelings felt inside the throat or chest
  • Difficulty in swallowing
  • 400;">Hives
  • Pain or stiffness in the joints
  • Ringing or buzzing heard in the ears that is not heard by others
  • Swelling of the extremities, face, fingers, or lower legs

Frequency of incidence not known:

  • Bruising without cause
  • Hot flushing
  • Pains

It is possible to overdose on this medication. If you believe that you or anyone else have overdosed on this medication then you should contact emergency services immediately. Common symptoms of overdose include:

  • Diarrhea
  • Dizziness or lightheadedness experienced when rising or standing up from lying or sitting down.
  • Quickening of or irregularity of heartbeat
  • Severe headaches

Other side effects that have not been listed herein may also occur. If other side effects do occur then you should contact your doctor for advice. If you are concerned about your immediate wellbeing then you should always contact the emergency services.

Dosage

This medication should be used only as prescribed by your doctor. You should not change the prescribed dose, change the frequency of dosing, or take this medication for longer than it was prescribed.

This medication should be provided with a medication guide booklet that you should read and understand before use. Ask your doctor if you have any questions bout the information within.

This medication should be taken at the same time each day so that you are able to form a habit and are less likely to miss a dose. Do not each grapefruit or drink grapefruit juice when using this medication.

The dose of this medication will be different for each and every patient. The dose you are prescribed will depend on a range of factors including weight, age, medical condition and the strength of the treatment. The following is a guideline only and you should always follow your doctor's instructions:

For the treatment of circulation problems:

  • Adults: 100mg twice daily. Medication should be taken at least 30 minutes before eating or at least 2 hours after eating. Dose may be adjusted to 50mg twice daily if used in conjunction with certain other medications.
  • Children: Use and dose should be determined by the doctor.

You should do all you can to avoid missing a dose of this medication. If you do miss a dose then you should take it as soon as possible unless it is close to the time that you are due your next dose. In this case, you should skip the dose and return to your usual schedule. Do not ever take a double dose of the medication.

Interactions

This medication has a wide range of interactions with other medications. In some cases medications can react violently with one another, putting the patient at risk. In other cases, medications can prevent each other from working. You should ensure that you inform your doctor of all medications that you are taking before you begin use of this treatment.

The following medications are not recommended for use with Cilostazol. If you are taking one or more of the following then your doctor may need to change your prescription:

  • Riociguat
  • Defibrotide

The use of the following medications would not normally be recommended. In some cases, you may be prescribed both but your doctor may wish to adjust the dose or frequency of one or more of the medications.

  • Vortioxetine
  • Voriconazole
  • Vilazodone
  • Verapamil
  • Venlafaxine
  • Valdecoxib
  • Tolmetin
  • Tolfenamic Acid
  • Tirofiban
  • Tipranavir
  • Ticlopidine
  • Ticagrelor
  • Tiaprofenic Acid
  • Tenoxicam
  • Telithromycin
  • Telaprevir
  • Sulindac
  • Sulfinpyrazone
  • Sodium Salicylate
  • Sertraline
  • Saquinavir
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Rivaroxaban
  • Ritonavir
  • Regorafenib
  • Rabeprazole
  • Protein C
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Prasugrel
  • Posaconazole
  • Piroxicam
  • Piracetam
  • Piperaquine
  • Piketoprofen
  • Phenylbutazone
  • Phenprocoumon
  • Phenindione
  • Paroxetine
  • Parecoxib
  • Pantoprazole
  • Oxyphenbutazone
  • Oxcarbazepine
  • Oxaprozin
  • Omeprazole
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Nilotinib
  • Niflumic Acid
  • Netupitant
  • Nepafenac
  • Nelfinavir
  • Nefazodone
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Moclobemide
  • Milnacipran
  • Mifepristone
  • Miconazole
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lopinavir
  • Levomilnacipran
  • Letrozole
  • Lepirudin
  • Lansoprazole
  • Ketorolac
  • Ketoprofen
  • Ketoconazole
  • Itraconazole
  • Indomethacin
  • Indinavir
  • Imatinib
  • Idelalisib
  • Ibuprofen
  • Heparin
  • Ginkgo
  • Fosaprepitant
  • Fondaparinux
  • Fluvoxamine
  • Flurbiprofen
  • Fluoxetine
  • Flufenamic Acid
  • Fluconazole
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Etravirine
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Esomeprazole
  • Eslicarbazepine Acetate
  • Escitalopram
  • Erythromycin
  • Eptifibatide
  • Edoxaban
  • Duloxetine
  • Droxicam
  • Dronedarone
  • Dipyrone
  • Dipyridamole
  • Diltiazem
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Desvenlafaxine
  • Desirudin
  • Delavirdine
  • Danaparoid
  • Dabigatran Etexilate
  • Crizotinib
  • Conivaptan
  • Cobicistat
  • Clopidogrel
  • Clonixin
  • Clarithromycin
  • Citalopram
  • Ciprofloxacin
  • Choline Salicylate
  • Ceritinib
  • Celecoxib
  • Bufexamac
  • Bromfenac
  • Boceprevir
  • Bivalirudin
  • Atazanavir
  • Aspirin
  • Argatroban
  • Aprepitant
  • Apixaban
  • Anagrelide
  • Amtolmetin Guacil
  • Amiodarone
  • Alteplase, Recombinant
  • Alipogene Tiparvovec
  • Acemetacin
  • Aceclofenac
  • Abiraterone
  • Abciximab

This medication can also interact with some foodstuffs. Patients should avoid the consumption of the following when taking Cilostazol:

  • Bitter orange
  • Grapefruit
  • Grapefruit juice

Medication use can also be impacted by other medical problems from which you might suffer. You should inform your doctor of any medical conditions that you have or have had in the past before beginning this treatment. This is particularly important if you suffer from any of the following:

Do not use in patients who suffer from the following:

  • Active bleeding
  • Blood clotting problems
  • Congestive heart failure

The following conditions may be worsened by use of Cilostazol:

  • Heart rhythm problems
  • History of ischemic heart disease
  • Kidney disease
  • Leukopenia
  • 400;">Liver disease
  • 400;">Thrombocytopenia

Other interactions not listed herein may also occur. Ensure that you inform your doctor of any conditions from which you suffer, any medications you are taking and any other pertinent information about substance use.

Warnings

Before deciding to commence use of this medication you should consider the risks of doing so in relation to the benefits that taking this medication will gain. You should make this decision having considered the following with your doctor:

Allergies: If you have ever reacted unusually to medication before then it is vital that you inform your doctor of this. Inform your doctor of any other allergies from which you suffer too.

Pediatric: Safe and effective use has not be determined in children. Discuss use with your doctor.

Geriatric: No known limitation exists that should prevent elderly patients from using this medication. Be cautious of other medical conditions that may affect the use of the medication.

Pregnancy: Risk to the fetus will occur from the use of this treatment when pregnant. You should inform your healthcare professional that you are pregnant before beginning treatment with this medication and you should inform your doctor if you think you may get pregnant during use.

Breastfeeding: Risk is unknown. You should discuss this with your doctor and weigh the benefits against the risks of breastfeeding.

This medication can take a number of weeks before it will have a noticeable effect. If you don't think it is working you should talk to your doctor. Do not stop the use of the medication unless ordered too.

Blood tests may be required during use to check for unwanted side effects that may be occurring. You will need to check in with your doctor regularly when you first start using this treatment to ensure that it is having the desired effect and is not having unwanted effects.

Cilostazol can lower the white blood cell count in the patient temporarily. This will increase the risk of developing an infection. The following special precautions should be taken to avoid infections during this period:

  • Avoid people who have an infection. This included coughs, colds and viruses.
  • Check in with your doctor immediately if you suspect you are getting an illness.
  • If you experience any unusual bleeding, bruising or blood in excretions then you should check in with your doctor immediately.
  • Seek alternative methods for cleaning your teeth that do not require the use of a toothbrush, dental floss or toothpick, which can all cause bleeding.
  • Wash your hands thoroughly before touching the eyes or the inside of the nose.
  • Be especially careful when you are handling sharp objects.
  • Avoid sports where contact is made or activities in which bruising or injury could occur.

Patients may experience dizziness or lightheadedness when rising from a lying or sitting position when taking this medication. Rise slowly to avoid this from happening and to prevent fainting.

This medication can be made less effective and your condition can be made worse by the use of tobacco products. It is best to avoid smoking when using this treatment. If you are a smoker then you should discuss this with your doctor.

Medications similar to Cilostazol are known to have caused an increased risk of death in patients with congestive heart failure. This medication should not be prescribed to patients who have suffered from this in the past.

Storage

This medication should be stored in a closed and sealed container at room temperature. Keep the medication away from heat, moisture and direct light. Prevent the medication from freezing. All medications should be kept away from children at all times. Discuss safe disposal of unwanted or outdated medication with your doctor.

Summary

Cilostazol is used to treat poor circulation of the blood. It is used in patients who are suffering from intermittent claudication which is the poor circulation of blood in the legs. This medical condition causes pain in the legs, particularly when walking because the muscles become starved of oxygen.

Cilostazol works by preventing the blood from clotting in the leg and by dilating the blood vessels to allow for the easier flow of blood and the better transfer of oxygen to the muscles.

When the patient starts taking this medication it can take a short period of time for the treatment to start working. Patients should keep taking the treatment for several weeks despite this until the desired effect occurs. Once treatment has started it should be continued as directed by the doctor unless you are ordered otherwise.

Side effects can occur from the use of this medication that you should be aware of. Patients should familiarize themselves with symptoms of significant problems that could occur before beginning use so that they know how to react to certain side effects should they occur.

Patients who smoke will find this treatment less effective. This is because the use of tobacco has a contrary effect on the blood vessels to the medication and therefore the treatment will be less effective. Smoking can also worsen the condition that is being treated. Patients should avoid smoking and should seek medical advice on how to stop smoking during use of this treatment.

This medication should not be used in patients suffering from certain conditions of the heart. Inform your doctor of all medical conditions from which you suffer before taking this treatment.

Resources
Last Reviewed:
January 30, 2018
Last Updated:
April 12, 2018