Aplet

Indications

Cilostazol is used to relieve the symptoms of intermittent claudication, which is cramping pain in the legs when walking, caused by narrowed arteries in the legs (peripheral arterial disease). It helps people walk further before the pain starts. It is used when lifestyle changes such as stopping smoking and regular walking exercise have not helped enough.

How It Works

Cilostazol blocks an enzyme called phosphodiesterase 3 (PDE3). This relaxes and widens the blood vessels in the legs and makes blood platelets less sticky, so blood flows more easily to the leg muscles.

Dosage and Administration

The usual adult dose is 100 mg twice a day, taken 30 minutes before or 2 hours after breakfast and the evening meal, because food increases its absorption. A lower dose of 50 mg twice a day may be used if you take certain interacting medicines. Benefit may take 4 to 12 weeks to appear; the doctor will review whether to continue after about 3 months.

Interactions

Medicines that block the liver enzymes that break it down, such as Erythromycin, Clarithromycin, Ketoconazole, Itraconazole, Diltiazem and Omeprazole, can raise its level; the dose may need lowering. Using it with Aspirin, Clopidogrel, Warfarin or other blood thinners raises the risk of bleeding. Grapefruit juice should be avoided.

Contraindications

Do not use if you have heart failure of any severity, a history of serious heart rhythm problems, unstable angina or a heart attack or heart surgery within the last 6 months, active bleeding or a high bleeding risk (such as an active stomach ulcer or recent stroke with bleeding), severe kidney or moderate to severe liver disease, or if you are allergic to it, pregnant or breastfeeding.

Side Effects

Common side effects include headache, diarrhoea, loose stools, dizziness, a fast or pounding heartbeat (palpitations), swelling of the ankles, nausea and runny nose. Headache often settles after the first few weeks.

Get urgent medical help if you have chest pain, a very fast or irregular heartbeat, fainting, shortness of breath or sudden swelling (signs of heart problems), unusual bleeding or bruising, black stools or vomiting blood, or signs of an allergic reaction.

Pregnancy and Lactation

Do not use during pregnancy or while breastfeeding.

Precautions and Warnings

Tell your doctor about any heart condition, bleeding problems, or planned surgery or dental work; it may need to be stopped about 5 days before an operation. Blood counts may be checked. Stopping smoking greatly improves leg circulation and should be part of treatment.

Overdose

Overdose may cause severe headache, diarrhoea, low blood pressure, fast heartbeat and irregular heart rhythm. Get medical help immediately.

Therapeutic Class

Phosphodiesterase 3 inhibitor; peripheral vasodilator and antiplatelet agent.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.