Pletal Drug Information

CILOSTAZOL (Systemic)†

Some frequently used brand names are:

In the U.S.—

• Pletal

† Not tradable 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 (RX medicine), in the dosage form provided below:

• Oral
• Tablets (U.S.)

Before Using This Medicine

When deciding if it's worth using a medicine, the risk of taking it must be carefully weighed against the benifit it can do. This is the decision you and your doctor are to make together. Concerning cilostazol, the following aspects should be taken into account:

Allergies—Inform your doctor if you have ever experienced 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 if 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 such cases, your doctor may advise you to change the dose, or other precautions may be required. When you are taking cilostazol, it is essential to tell your health care professional 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 existence of other medical problems may influence the use of /cilostazol. You should tell your doctor if you have any other medical problems, in particular::

• 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 vary for different patients. Adhere to the orders of your doctor or the instructions on the label. The following information includes on the average doses of cilostazol. If your dose differs, you should 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. You should not double doses.

Storage—To store this medicine properly, follow the instructions below:

• 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

Alongside with its expected effects, any medicine may be the cause of some unwanted effects. Although not all of these side effects may happen, if they do happen they may require medical attention.

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

Less common

Symptoms of overdose

Other side effects that may occur generally do not require any medical attention. These side effects may disappear in the course of treatment as your body gets used to the medicine. Nevertheless, inform your doctor if any of the side effects below persist or became annoying:

More common

Other side effects not mentioned above may also happen in some patients. If you notice any other effects, tell your doctor about it.