Drug reference
Intermittent claudication in patients without rest pain and no peripheral tissue necrosis ▶BY MOUTH ▶Adult: 100 mg twice daily, to be taken 30 minutes before food, cilostazol should be initiated by those experienced in the management of intermittent claudication, patients receiving cilostazol should be assessed for improvement after 3 months; consider discontinuation of treatment if there is no clinically relevant improvement in walking distance
PDF page 268
DUE TO INTERACTIONS ▶Manufacturer advises reduce dose to 50 mg twice daily with concurrent use of potent inhibitors of CYP3A4, potent inhibitors of CYP2C19, omeprazole and erythromycin.
PDF page 268
Active peptic ulcer. congestive heart failure. coronary intervention in previous 6 months. haemorrhagic stroke in previous 6 months. history of severe tachyarrhythmia. myocardial infarction in previous 6 months. poorly controlled hypertension. predisposition to bleeding. proliferative diabetic retinopathy. prolongation of QT interval. unstable angina. ventricular arrhythmia
PDF page 268
Atrial fibrillation. atrial flutter. atrial or ventricular ectopy. diabetes mellitus (higher risk of intraocular bleeding). stable coronary disease. surgery
PDF page 268
NICE decisions ▶Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease (May 2011) NICE TA223 Cilostazol is not recommended for the treatment of intermittent claudication in patients with peripheral arterial disease; patients currently receiving this treatment should have the option to continue until they and their clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta223
PDF pages 268, 269
→Appendix 1: cilostazol
PDF page 268
▶Common or very common Appetite decreased. arrhythmias . diarrhoea. dizziness. gastrointestinal discomfort. gastrointestinal disorders. headache. increased risk of infection. nausea. oedema. palpitations. skin reactions. vomiting ▶Uncommon Anaemia. anxiety. congestive heart failure. cough. dyspnoea. haemorrhage. hyperglycaemia. hypotension. sleep disorders. syncope ▶Rare or very rare Renal impairment. thrombocytosis ▶Frequency not known Agranulocytosis. bone marrow disorders. conjunctivitis. fever. granulocytopenia. hepatic disorders. hot flush. hypertension. intracranial haemorrhage. leucopenia. paresis. severe cutaneous adverse reactions (SCARs). thrombocytopenia. tinnitus. urinary frequency increased
PDF page 268
Avoid—toxicity in animal studies.
PDF page 268
Present in milk in animal studies— manufacturer advises avoid.
PDF page 268
Manufacturer advises avoid in moderate-to-severe impairment—no information available.
PDF page 268
Avoid if eGFR less than 25 mL/minute/1.73 m2.
PDF page 268
There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Cilostazol (Non-proprietary) Cilostazol 50 mg Cilostazol 50mg tablets | 56 tablet P £40.08 DT = £40.08 Cilostazol 100 mg Cilostazol 100mg tablets | 56 tablet P £33.37 DT = £5.66 ▶Pletal (Otsuka Pharmaceuticals (U.K.) Ltd) Cilostazol 50 mg Pletal 50mg tablets | 56 tablet P £35.31 DT = £40.08 Cilostazol 100 mg Pletal 100mg tablets | 56 tablet P £33.37 DT = £5.66 LIPID MODIFYING DRUGS › NICOTINIC ACID DERIVATIVES
PDF page 269
Blood disorders Patients should be advised to report any unexplained bleeding, bruising, sore throat, or fever.
PDF page 268
100 mg twice daily, to be taken 30 minutes
First-line fragment. Read the complete Indications and Dose section above.
PDF page 268
