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|Cilostazol

CILOSTAZOL (Systemic)†

Some commonly used brand names are:

In the U.S.—

• Pletal

† Not commercially available in Canada.

Category

• Platelet aggregation inhibitor
• vasodilator

Description

Cilostazol (sil-OH-sta-zol) improves the flow of blood through blood vessels. It is used to reduce leg pain caused by poor circulation (intermittent claudication). Cilostazol makes it possible to walk farther before having to rest because of leg pain.

Cilostazol works by keeping blood from clotting and by dilating or relaxing the blood vessels.

Cilostazol is available only with your doctor"s prescription, in the following dosage form:

• Oral
• Tablets (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For cilostazol, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to cilostazol. Also tell your healthcare professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Tell your doctor if you are pregnant or if you intend to become pregnant. Studies in rats and rabbits have shown that cilostazol may cause some birth defects. Be sure that you have discussed this with your doctor before taking this medicine. Tell your doctor right away if you think you have become pregnant while receiving cilostazol.

Breast-feeding—It is not known whether cilostazol passes into human breast milk. However, cilostazol has been shown to pass into the breast milk of rats. Cilostazol is not recommended during breast-feeding because it may cause unwanted effects in nursing babies.

Children— Studies on this medicine have been done only in adult patients, and there is no specific information comparing the use of cilostazol in children with use in other age groups.

Older adults—This medicine has been tested in a limited number of patients and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases, two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking cilostazol, it is especially important that your health care professional know if you are taking any of the following:

• Diltiazem (e.g., Cardizem, Cardizem CD, Cardizem SR) or
• Erythromycin (medicine for infection) or
• Fluconazole (e.g., Diflucan) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Miconazole (e.g., Lotrimin, Monistat) or
• Nefazodone (e.g., Serzone) or
• Omeprazole (e.g., Prilosec) or
• Selective serotonin reuptake inhibitors (fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox]), paroxetine [e.g., Paxil], sertraline [e.g., Zoloft])—Use with these medicines may cause high levels of cilostazol, which may increase the chance of side effects

Other medical problems—The presence of other medical problems may affect the use of cilostazol. Make sure you tell your doctor if you have any other medical problems, especially:

• Congestive heart failure or
• Kidney disease—May increase the chance of side effects

Proper Use of This Medicine

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

Dosing—The dose of cilostazol will be different for different patients. Follow your doctor"s orders or the directions on the label. The following information includes on the average doses of cilostazol. If your dose is different, do not change it unless your doctor tells you to do so.

• For oral dosage form (tablets):

—For treatment of peripheral vascular disease (circulation problems):

• Adults—100 milligrams (mg) two times a day, taken at least one half hour before or two hours after breakfast and dinner. In patients who take certain other medicines at the same time as cilostazol, the dose may be 50 mg two times a day.
• Children—Use and dose must be determined by a doctor.

Missed dose—If you miss a dose of this medicine, 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 dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It may take several weeks for this medicine to work. If you feel that cilostazol is not working, do not stop taking it on your own. Instead, check with your doctor.

Smoking tobacco products, such as cigarettes, may worsen your condition since nicotine may further narrow blood vessels and may also affect how this medicine works. Therefore, it is best to avoid smoking.

You should not take cilostazol with grapefruit juice. You may, however, take it with other citrus juices.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur :

Less common

Symptoms of overdose

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 11/02/1999
Revised: 04/20/2001

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