Cilostazol contains cilostazol and is used to improve blood flow in patients with peripheral arterial disease (PAD), particularly those experiencing intermittent claudication (leg pain while walking). Peripheral arterial disease occurs when narrowed arteries reduce blood flow to the limbs, causing pain, cramping, or fatigue during physical activity. Cilostazol works by widening blood vessels and reducing the clumping of platelets, which improves circulation and oxygen delivery to muscles. Cilostazol helps patients walk longer distances with less pain and enhances overall mobility and quality of life.

Cilostazol contains cilostazol, a phosphodiesterase III (PDE3) inhibitor used primarily to treat intermittent claudication in patients with peripheral arterial disease. It improves blood circulation by acting on both blood vessels and platelets.

Cilostazol works by inhibiting the enzyme phosphodiesterase III, which increases levels of cyclic adenosine monophosphate (cAMP) in platelets and blood vessel walls. Elevated cAMP levels cause blood vessels to relax and widen (vasodilation) and reduce platelet aggregation (clot formation). This dual effect enhances blood flow, particularly to the legs and extremities.

By improving arterial circulation, Cilostazol reduces symptoms such as leg pain, cramping, and fatigue during walking. Patients often notice improved walking distance and exercise tolerance after several weeks of consistent treatment.

Cilostazol is metabolised in the liver and eliminated through urine and faeces. It is not recommended in patients with heart failure due to its PDE3 inhibitory action. When used appropriately, Cilostazol provides effective symptom relief and supports vascular health in patients with circulatory disorders.

Intermittent Claudication

Improves walking distance and reduces leg pain in patients with peripheral arterial disease.

Peripheral Arterial Disease (PAD)

Enhances blood flow in narrowed arteries supplying the limbs.

Prevention of Platelet Aggregation

Helps reduce the risk of clot formation in specific vascular conditions (as advised by a doctor).

Post-Vascular Procedures (Selective Use)

Sometimes used after certain vascular interventions to improve circulation.

Improves Walking Distance

Helps patients walk longer without pain.

Vasodilatory Effect

Widens blood vessels to enhance circulation.

Antiplatelet Action

Reduces platelet clumping and clot formation.

Enhanced Oxygen Delivery

Improves blood supply to muscles during activity.

Quality of Life Improvement

Reduces discomfort and improves mobility in PAD patients.

Dual Mechanism

Combines vasodilation and antiplatelet effects for comprehensive vascular support.

When taken as directed, Cilostazol is generally well tolerated. Side effects are usually mild and may reduce over time.

Common Side Effects:

• Headache

• Diarrhoea

• Dizziness

• Palpitations

• Abnormal stools

Uncommon Side Effects:

• Rapid heart rate (Tachycardia)

• Low blood pressure

• Peripheral oedema (swelling)

• Nausea

Serious Side Effects (Require Immediate Medical Attention):

• Chest pain or worsening angina

• Severe bleeding or bruising

• Irregular heartbeat

Allergic reactions such as rash, swelling, or difficulty breathing

Cilostazol should be taken exactly as prescribed by your doctor. The usual dose is one 50mg tablet twice daily, taken at least 30 minutes before or 2 hours after meals for optimal absorption.

Swallow the tablet whole with water. Do not crush or chew it. Consistent daily use is important for maximum benefit, and improvements may be noticeable after 2-4 weeks of therapy.

The mechanism of Cilostazol is based on phosphodiesterase III inhibition. Cilostazol inhibits PDE3, an enzyme responsible for breaking down cyclic AMP (cAMP). Increased cAMP levels in platelets reduce platelet aggregation, lowering the risk of clot formation. In blood vessel walls, elevated cAMP causes relaxation of smooth muscle cells, leading to vasodilation. This widens narrowed arteries and improves blood flow, especially to the legs. The combined effect of improved circulation and reduced clotting helps relieve symptoms of intermittent claudication and enhances physical activity tolerance.

• Consistent Dosing: Take regularly for best symptom improvement.

• Walking Program: Combine with supervised exercise therapy for optimal benefit.

• Avoid Smoking: Smoking worsens peripheral arterial disease.

• Monitor Heart Symptoms: Report chest pain or irregular heartbeat immediately.

• Bleeding Precautions: Inform your doctor if you notice unusual bruising or bleeding.

• Medication Disclosure: Inform your healthcare provider about all medicines you are taking.

• Regular Follow-Up: Periodic monitoring improves long-term vascular health.

• Alcohol (Moderate): May increase dizziness and bleeding risk.

• High-Fat Meals (Moderate): May alter absorption; take on empty stomach.

• Grapefruit (Moderate): May affect drug metabolism; use cautiously.

• Antiplatelets/Anticoagulants (High): Increased bleeding risk with Aspirin, Clopidogrel, or Warfarin.

• CYP3A4 Inhibitors (Moderate-High): Drugs like Erythromycin or Ketoconazole may increase cilostazol levels.

• CYP2C19 Inhibitors (Moderate): Omeprazole may increase blood levels.

• Other Vasodilators (Moderate): May cause excessive lowering of blood pressure.

• NSAIDs (Moderate): Increased bleeding risk.

• Heart Failure (High): Contraindicated due to increased mortality risk.

• Bleeding Disorders (High): May increase bleeding tendency.

• Liver Disease (Moderate): Dose adjustment may be needed.

• Kidney Disease (Moderate): Use with caution.

• Arrhythmias (Moderate): May increase heart rate in susceptible patients.

If you miss a dose, take it as soon as you remember unless it is nearly time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule.

Do not take a double dose to make up for the missed one.