Description
Cilostazol
Generic Medicine InfoPatient Medicine Information
This information is not country-specific. Please refer to the Philippines prescribing information.
Generic Medicine Info
Indications and Dosage Oral Adult: In patients without rest pain or peripheral tissue necrosis; as second-line in patients for whom lifestyle modifications and drug treatment or interventions are insufficient: 100 mg bid. Reassess therapy after 3 months. |
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Special Patient Group Patient taking strong or moderate inhibitors of CYP3A4 or CYP2C19 (e.g. certain macrolides, azole antifungals, protease inhibitors, proton pump inhibitors): 50 mg bid. |
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Renal Impairment
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Hepatic Impairment Moderate or severe: Contraindicated. |
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Administration Should be taken on an empty stomach. Take at least 30 min before or 2 hr after meals. |
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Contraindications Congestive heart failure (of any grade or severity), history of ventricular tachycardia, fibrillation or multifocal ventricular ectopic beats, severe tachyarrhythmia; unstable angina pectoris, myocardial infarction or coronary intervention within the last 6 months; prolonged QTc interval, known predisposition to bleeding (e.g. active peptic ulceration, recent haemorrhagic stroke, proliferative diabetic retinopathy, uncontrolled hypertension) or any active or uncontrolled bleeding. Severe renal (CrCl ≤25 mL/min) and moderate or severe hepatic impairment. Pregnancy and lactation. Concomitant use with ≥2 additional antiplatelet or anticoagulant agents (e.g. aspirin, clopidogrel, heparin, warfarin, dabigatran, rivaroxaban or apixaban). |
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Special Precautions Patients with stable coronary disease, atrial or ventricular ectopy, atrial fibrillation or flutter. Surgery including minor invasive measurements (e.g. tooth extraction). Patients taking strong or moderate inhibitors of CYP3A4 or CYP2C19 (e.g. certain macrolides, azole antifungals, protease inhibitors, proton pump inhibitors). |
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Adverse Reactions Significant: Tachycardia, palpitation, tachyarrhythmia, hypotension, thrombocytopenia, leucopenia, agranulocytosis. |
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PO: C |
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Patient Counseling Information This drug may cause dizziness, if affected, do not drive or operate machinery. |
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Monitoring Parameters Monitor platelets and WBC count periodically, development of systolic murmur, cardiac symptoms, or signs of bleeding. |
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Overdosage Symptoms: Severe headache, diarrhoea, hypotension, tachycardia, cardiac arrhythmias. Management: Supportive treatment. Perform gastric lavage or induce vomiting as necessary to empty stomach contents. |
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Drug Interactions Increased serum concentration with strong or moderate inhibitors of CYP3A4 (e.g. erythromycin, ketoconazole, itraconazole, diltiazem) or CYP2C19 (e.g. omeprazole, fluconazole, ticlopidine). Increased serum concentrations of CYP3A4 substrates (e.g. lovastatin, simvastatin, atorvastatin) or other CYP3A4 substrates with narrow therapeutic index (e.g. cisapride, halofantrine, pimozide, ergot alkaloids). |
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Food Interaction Increased serum concentration with high-fat meal and grapefruit juice. |
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Action Description: Cilostazol inhibits phosphodiesterase-III (PDE-III) resulting to increased cyclic adenosine monophosphate (cAMP) thereby leading to reversible inhibition of platelet aggregation, vasodilation, and inhibition of vascular smooth muscle cell proliferation. |
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Chemical Structure
Cilostazol Source: National Center for Biotechnology Information. PubChem Database. Cilostazol, CID=2754, https://pubchem.ncbi.nlm.nih.gov/compound/Cilostazol (accessed on Jan. 21, 2020) |
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Storage Store at 25°C. |
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MIMS Class Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics) |
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ATC Classification B01AC23 – cilostazol ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis. |