Cilostazol

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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

Interactions

  • Abciximab
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