Cilostazol

Cilostazol is used in the treatment of pain in legs due to insufficient blood flow (intermittent claudication). It also helps in reducing cramping, numbness, or weakness in the legs that occurs on walking in such patients. Cilostazol should be taken regularly as advised by the doctor. You should take it on an empty stomach and at a fixed time. This medicine should not be stopped abruptly without consulting the doctor. It may cause side effects like headache, edema, nausea, diarrhea, dizziness and chest pain. Use of this medicine may increase your risk of bleeding.

Cilostazol widens the blood vessels and decreases the stickiness of the platelets, thereby increasing the blood flow to the lower limbs.

• Intermittent claudication (pain in legs due to insufficient blood flow)

Cilostazol is a quinolinone derivative. The mechanism of action is to specifically inhibit cellular phosphodiesterase III (PDE III) and suppress cAMP degradation with a resultant increase in cAMP in platelets and blood vessels, leading to inhibition of platelet aggregation and vasodilation.

Cilostazol is a reversible, selective inhibitor of phosphodiesterase-III (PDE-III), thereby suppressing cyclic adenosine monophosphate (cAMP) degradation. Increase in cAMP in platelets and blood vessels leads to inhibition of platelet aggregation and vasodilation. Cilostazol also inhibits adenosine uptake into cells, which augments the cAMP-elevating effect of PDE-III inhibition.

Adult Dose (Oral): 100 mg twice daily (at least half an hour before or two hours after breakfast and dinner).

Dose Reduction: Consider 50 mg twice daily during coadministration of Fluconazole, Ketoconazole, Itraconazole, Erythromycin, Clarithromycin, Fluvoxamine, Fluoxetine, Nefazodone, Sertraline and Diltiazem.

Hepatic Dose: Moderate to severe: Use caution.

Renal Dose: CrCl <25 mL/min: Use caution.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Cilostazol is to be taken on an empty stomach (at least half an hour before or two hours after breakfast and dinner).

If you miss a dose of Cilostazol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Headache
• Palpitations
• Abnormal stool
• Diarrhea
• Dizziness
• Chest pain
• Loss of appetite
• Bleeding
• Rash
• Vomiting
• Leg cramps
• Edema

• [UNSAFE] Cilostazol may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
• Take it at least half an hour before or two hours after breakfast and dinner.
• It may take up to 12 weeks before your symptoms improve. Keep using the medication as directed.
• Consult your doctor if your symptoms do not improve after 4 weeks of treatment.
• Do not take it if you have heart failure, persistent chest pain at rest, or have had a heart attack or any heart surgery in the last six months.
• May increase risk of bleeding. Inform your doctor if you see pinpoint rash or blood in vomits, urine, or stool.

• Congestive heart failure of any severity
• Known predisposition to bleeding
• History of ventricular arrhythmias
• QT interval prolongation
• Severe renal impairment
• Moderate to severe hepatic impairment
• Hypersensitivity

Co-administration with drugs that affect CYP3A4 (erythromycin, other macrolides, diltiazem) or CYP2C19 (omeprazole) may influence the pharmacokinetics of cilostazol. Omeprazole and Erythromycin significantly increased the systemic exposure of Cilostazol. Population pharmacokinetic studies showed higher concentrations of Cilostazol among patients concurrently treated with Diltiazem.

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with Cilostazol. Please consult your doctor.

[CONSULT YOUR DOCTOR] Cilostazol may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor. Pregnancy Category C.

[CONSULT YOUR DOCTOR] Cilostazol is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby. Transfer of Cilostazol into milk has been reported in experimental animals.

The safety and effectiveness of Cilostazol in pediatric patients have not been established.

Limited information is available regarding dose adjustment for elderly patients.

[CAUTION] Cilostazol should be used with caution in patients with severe kidney disease. Dose adjustment of Cilostazol may be needed. Please consult your doctor. CrCl <25 mL/min: Use caution.

[CAUTION] Cilostazol should be used with caution in patients with liver disease. Dose adjustment of Cilostazol may be needed. Please consult your doctor. Use is not recommended in patients with moderate and severe liver disease.

Information on Cilostazol overdosage is not available. In case of overdose, symptomatic and supportive treatment should be given.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Cilostazol