CILOSTAZOL

Indications & Dose:

Intermittent claudication in patients without rest pain and no peripheral tissue necrosis l

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

DOSE ADJUSTMENTS DUE TO INTERACTIONS Reduce dose to 50 mg twice daily with concomitant use of potent inhibitors of cytochrome P450 enzymes CYP3A4 (e. g. clarithromycin, itraconazole, ketoconazole, protease inhibitors) or CYP2C19, or with erythromycin or omeprazole

Contraindications:

Congestive heart failure

Side Effects:

Cautions:

Precautions:

Congestive heart failure (several drugs with this pharmacologic effect have caused decreased survival compared with placebo in patients with class III-IV CHF), cardiovascular lesions, children

PREGNANCY AND LACTATION: Pregnancy category C; excreted in breast milk

Interaction:

Drugs 

Diltiazim: Increase cilostazol concentrations antifungals, fuoxetine, nefazadone, and sertraline: as CYP3A4 or CYP2C19 ‘inhibitors, may increase cilostazol levels; clinical effects unknown

Omeprazole: Increase cilostazol concentrations

Foods: Grapefruit Juice: Increases cilostazol levels;High fat: increases absorption of’ cilostazol (80% increase of Cmax. 25% increase of AUC)

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Dizziness, vertigo, headache

CV: Palpitations, tachycardia, peripheral edema

GI: Abnormal stool, diarrhea, dyspepsia, flatulence, nausea

MS: Back pain, myalgia

RESP: Cough, pharyngitis, rhinitis

MISC: Infection

Patient And Carer Advice: