Cilostazol

Cilostazol Brand Name– Pletal

What is Cilostazol

Cilostazol is a platelet aggregation inhibitor with vasodilating activity. It is the first new compound in over 15 years to be FDA approved for the reduction of the symptoms of intermittent claudication.

In all manufacturer-supported trials conducted in the US, patients treated with cilostazol had improvements in the maximum distance walked (ACD-absolute claudication distance) on a treadmill; or they had improvements in the time to initial pain, also known as pain-free walking distance or ICD (initial claudication distance).

In one clinical trial, patients treated with cilostazol for 12 weeks increased their pain-free walking distances (ICDs) 35% relative to placebo. On subjective assessments, more patients in the cilostazol group reported improvement in their symptoms.

Cilostazol is given the trade name “Pletaal” in Japan and other Pacific rim countries, where it has been available since 1988.

Non-FDA approved uses of cilostazol have included the treatment of Buerger’s disease, vascular sclerosis complicating diabetes mellitus, and the improvement of symptoms in patients with chronic cerebral ischemia.

The FDA approved cilostazol for the reduction of symptoms related to intermittent claudication on January 15, 1999.

Indications

1. Buerger’s disease
2. claudication
3. percutaneous coronary intervention (PCI)
4. peripheral vascular disease (PVD)

For the treatment of claudication associated with peripheral vascular disease (PVD); including the treatment of peripheral arterial disease in patients with diabetic neuropathy, and for the treatment of chronic arterial occlusion due to arteriosclerosis obliterans† or thromboangiitis obliterans† (Buerger’s disease)

Side Effects

1. abdominal pain
2. agranulocytosis
3. amblyopia
4. anemia
5. angina
6. anorexia
7. anxiety
8. aplastic anemia
9. arthralgia
10. asthenia
11. atrial fibrillation
12. atrial flutter
13. azotemia
14. back pain
15. bleeding
16. bone pain
17. cardiac arrest
18. chest pain (unspecified)
19. chills
20. cholelithiasis
21. colitis
22. conjunctivitis
23. cough
24. cystitis
25. diabetes mellitus
26. diarrhea
27. diplopia
28. dizziness
29. dyspepsia
30. dyspnea
31. ecchymosis
32. edema
33. elevated hepatic enzymes
34. epistaxis
35. esophagitis
36. fever
37. flatulence
38. furunculosis
39. gastritis
40. gout
41. headache
42. heart failure
43. hematemesis
44. hematoma
45. hematuria
46. hemoptysis
47. hot flashes
48. hyperglycemia
49. hyperlipidemia
50. hypertension
51. hyperuricemia
52. hypoesthesia
53. hypotension
54. increased urinary frequency
55. infection
56. influenza
57. insomnia
58. intracranial bleeding
59. jaundice
60. leukopenia
61. malaise
62. melena
63. myalgia
64. myocardial infarction
65. nausea
66. ocular hemorrhage
67. orthostatic hypotension
68. palpitations
69. paresthesias
70. peptic ulcer
71. peripheral edema
72. peripheral vasodilation
73. pharyngitis
74. platelet dysfunction
75. polycythemia
76. premature ventricular contractions (PVCs)
77. pruritus
78. purpura
79. QT prolongation
80. rash
81. retinal hemorrhage
82. retroperitoneal bleeding
83. rhinitis
84. sinus tachycardia
85. sinusitis
86. Stevens-Johnson syndrome
87. stroke
88. subdural hematoma
89. supraventricular tachycardia (SVT)
90. syncope
91. thrombocytopenia
92. thrombosis
93. tinnitus
94. urticaria
95. vaginal bleeding
96. vaginitis
97. ventricular tachycardia
98. vertigo
99. visual impairment
100. vomiting
101. xerosis

Monitoring Parameters

• CBC

Contraindications

• acute myocardial infarction
• angina
• bleeding
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• children
• coronary artery disease
• driving or operating machinery
• geriatric
• GI bleeding
• heart failure
• hepatic disease
• hypertension
• hypotension
• intracranial bleeding
• myocardial infarction
• peptic ulcer disease
• pregnancy
• renal failure
• renal impairment
• retinal bleeding
• retroperitoneal bleeding
• surgery
• tachycardia
• thrombocytopenia
• tobacco smoking
• trauma
• valvular heart disease
• ventricular tachycardia

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