Cilostazol is a quinolinone derivative and antiplatelet agent with vasodilating properties that has been used in the symptomatic treatment of intermittent claudication in patients with peripheral ischaemia. Cilostazol works by inhibiting both primary and secondary aggregation and reducing calcium-induced contractions.

Therapeutic Indication
Intermittent Claudication


Mechanism of Action:
Cilostazol reduces the symptoms of intermittent claudication, as indicated by an increased walking distance. Intermittent claudication is pain in the legs that occurs with walking and disappears with rest. The pain occurs due to reduced blood flow to the legs. Cilostazol and several of its metabolites are cyclic AMP (cAMP) phosphodiesterase III inhibitors (PDE III inhibitors), inhibiting phosphodiesterase activity and suppressing cAMP degradation with a resultant increase in cAMP in platelets and blood vessels, leading to inhibition of platelet aggregation and vasodilation.

Absorption: Cilostazol is absorbed after oral administration.
A high fat meal increases absorption, with an approximately 90% increase in Cmax and a 25% increase in AUC.
Absolute bioavailability is not known.
Protein binding: 95-98%
Metabolism: Cilostazol is extensively metabolized by hepatic cytochrome P-450 enzymes
Route of elimination: The primary route of elimination was via the urine (74%), with the remainder excreted in feces (20%). 
Half-life is 11-13 hours.

Side Effects
Common side effect of drug includes:
● Headache,
● Diarrhea,
● Vomiting,
● Abnormal stools,
● Dizziness,
● Weakness,
● Fast or pounding heartbeats,
● Palpitations.
Immediately discontinue the use if any severe side effects are observed and consult your physician.

Some products that may interact with this drug include:
● Anticoagulants (blood thinners) such as warfarin
● Aspirin
● Antifungal medications such as fluconazole, itraconazole, and ketoconazole
● Antiplatelet medications such as clopidogrel, prasugrel, and ticlopidine
● Clarithromycin
● Diltiazem
● Erythromycin
● Fluvoxamine
● Fluoxetine
● omeprazole
● Sertraline

This medication should not be consumed in following conditions:
● Decreased blood platelets
● Low levels of white blood cells
● Angina
● A type of chest pain
● Bleeding
● Chronic heart failure
● Neuraxial anesthesia
● Deep peripheral nerve block

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