Cilostazol

Generic Details

Generic Name

Cilostazol

Other Names

  • Pletal

Drug Class

  • Phosphodiesterase Inhibitor

Chemical Formula

C20H27N5O2

Molecular Weight

369.46 g/mol

Mechanism of Action

  • Cilostazol inhibits platelet aggregation and reduces smooth muscle cell proliferation.

Indications

  • Intermittent claudication (pain in the legs while walking due to decreased blood flow)

Common Dosage Forms

  • Tablet

Typical Dosage

  • 100 mg twice daily at least 30 minutes before or 2 hours after breakfast and dinner

Pediatric Dosage

  • Not established

Geriatric Dosage

  • Initiate therapy at the lower end of the adult dosing range

Side Effects

  • Headache
  • Diarrhea
  • Abnormal stools
  • Abdominal pain
  • Dizziness

Contraindications

  • History of heart failure
  • Severe hepatic dysfunction
  • Hypersensitivity to cilostazol or other related drugs

Pregnancy Category

  • C - Use with caution

Lactation Safety

  • Not recommended

Drug Interactions

  • Strong CYP3A4 inhibitors may increase cilostazol levels
  • Strong CYP3A4 inducers may decrease cilostazol levels

Overdose Symptoms

  • Severe headache
  • Diarrhea
  • Tachycardia

Antidote for Overdose

  • There is no specific antidote, treatment should be symptomatic and supportive

Storage Conditions

  • Store at room temperature between 20-25°C (68-77°F)

Pharmacokinetics

  • Absorption: Rapid and almost complete
  • Distribution: Protein binding is approximately 95%
  • Metabolism: Primarily hepatic via CYP3A4 and CYP2C19
  • Excretion: Mainly through urine (74%) and feces (20%)

Precautions

  • Use with caution in patients with bleeding disorders
  • Monitor for signs of heart failure exacerbation

Warnings

  • Increased risk of myocardial infarction and cardiovascular death in patients with heart failure