cilostazol at a glance
Medicine class
Phosphodiesterase-3 inhibitor with antiplatelet and vasodilator effects
Usual role
Second-line treatment to improve pain-free and maximum walking distance in intermittent claudication
Food
Take on an empty stomach before food because food can increase exposure and adverse effects
Important limitation
It does not replace smoking cessation, exercise or treatment to reduce cardiovascular risk
What is cilostazol used for?
Licensed use represented by the selected product:
Improving maximum and pain-free walking distance in adults with intermittent claudication who have no rest pain or peripheral tissue necrosis.
Second-line use after lifestyle changes and other appropriate interventions have not sufficiently improved symptoms.
How does cilostazol work?
Cilostazol inhibits phosphodiesterase-3, increasing cyclic AMP inside platelets and blood-vessel tissue. This reversibly reduces platelet aggregation and promotes vasodilation, which can improve walking capacity.
cilostazol preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg, 100 mg
How to take cilostazol
Take cilostazol exactly as prescribed. Swallow the tablets with water on an empty stomach before food.
Continue agreed smoking-cessation, exercise and cardiovascular-risk treatments.
If dizziness occurs, do not drive or operate machinery until it has resolved.
Tell a doctor or dentist that you take cilostazol before surgery or dental procedures.
cilostazol side effects
Common or expected effects
- Headache
- Diarrhoea or abnormal stools
- Palpitations or a fast heartbeat
- Dizziness
- Nausea, indigestion, wind or abdominal pain
- Ankle, foot or facial swelling
- Rash or itching
- Weakness
Get urgent medical advice
- Chest pain, heart attack symptoms, fainting or a new or worsening abnormal heartbeat
- Significant or unexplained bleeding
- Fever or sore throat, particularly with bruising or bleeding
- Severe blistering, peeling or widespread skin reaction
- Yellow skin or eyes
- Severe breathlessness or signs of heart failure
- Symptoms of stroke
cilostazol in pregnancy
Cilostazol is contraindicated during pregnancy because human data are inadequate and animal studies found reproductive toxicity. Contact the prescriber promptly if pregnant, planning pregnancy or becoming pregnant while taking it.
cilostazol while breastfeeding
Cilostazol is not recommended while breastfeeding. It is unknown whether it enters human milk, and a potential risk to the infant cannot be excluded; specialist or prescriber review is needed.
cilostazol interactions
A full medicines review is important because cilostazol affects platelets and is extensively metabolised by CYP enzymes.
Aspirin, clopidogrel and other antiplatelets
Bleeding risk may increase. Cilostazol is contraindicated with two or more additional antiplatelet or anticoagulant medicines.
Warfarin, heparins and direct oral anticoagulants
The combination can increase bleeding risk and requires prescriber review. Two or more additional antithrombotic medicines are contraindicated.
Strong CYP3A4 inhibitors, including some macrolides, azole antifungals and protease inhibitors
Common questions about cilostazol
Answers are fully visible for fast scanning and source review.
What is cilostazol used for?
It is licensed to improve pain-free and maximum walking distance in intermittent claudication when lifestyle measures and other appropriate interventions have not worked well enough.
Does cilostazol cure peripheral arterial disease?
No. It may improve walking symptoms but does not remove the underlying arterial disease or replace exercise, smoking cessation and cardiovascular-risk treatment.
Can cilostazol cause bleeding?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.