Cilostazol Medicines

Cilostazol is a platelet aggregation inhibitor and vasodilator used to treat symptoms of intermittent claudication in peripheral artery disease by improving leg circulation.

Pletal

Cilostazol

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50 | 100mg

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About Cilostazol

Cilostazol is a phosphodiesterase-3 (PDE3) inhibitor approved primarily for the improvement of walking distance in adults with intermittent claudication due to peripheral arterial disease. By increasing cyclic adenosine monophosphate (cAMP) within platelets and vascular smooth-muscle cells, it reduces platelet aggregation and induces vasodilation, which together enhance blood flow to the lower limbs. The drug is marketed under several brand names, including Pletal® and Cilostazol-Mylan®, and is widely available in generic form through our online pharmacy. While its main indication focuses on peripheral vascular disease, clinicians occasionally employ it off-label for cerebrovascular prophylaxis in selected high-risk patients, though such use remains outside official approval. Understanding its pharmacology, dosing strategies, and safety profile helps patients make informed choices when considering Cilostazol as part of a comprehensive treatment plan.

What is Cilostazol?

Cilostazol belongs to the class of selective phosphodiesterase-3 inhibitors, a subgroup of antiplatelet agents that also promote vasodilation. The Therapeutic Goods Administration (TGA) of Australia approved the medication in 2002 for intermittent claudication, following earlier approval by the U.S. Food and Drug Administration (FDA) in 1999. The European Medicines Agency (EMA) later expanded its label to include secondary prevention of stroke in certain populations, although that indication is not adopted in Australia.

At the molecular level, Cilostazol blocks the PDE3 enzyme, preventing the breakdown of cAMP. Elevated intracellular cAMP decreases calcium influx in platelets, inhibiting their aggregation, while simultaneously relaxing vascular smooth-muscle cells to improve blood vessel caliber. These combined actions translate into better perfusion of ischemic limb muscles during exercise.

Both branded formulations such as Pletal® and a range of generic tablets are distributed through our pharmacy service, offering patients flexibility in choosing cost-effective options without compromising quality.

How Cilostazol Works

Mechanism of Action

Cilostazol competitively inhibits phosphodiesterase-3, leading to accumulation of cAMP in platelets and smooth-muscle cells. The rise in cAMP activates protein kinase A, which phosphorylates downstream targets that reduce platelet activation and promote smooth-muscle relaxation.

Therapeutic Effects

By curbing platelet clumping, the drug diminishes microthrombus formation in peripheral arteries. Concurrent vasodilation lowers peripheral vascular resistance, allowing more oxygen-rich blood to reach the muscles of the calf and thigh during ambulation. Clinically, patients report increased maximal walking distance and reduced onset of leg pain.

Onset and Duration

Clinical trials indicate that measurable improvement in walking distance can be observed after 2-4 weeks of consistent therapy. Steady-state plasma concentrations are reached within 5-7 days of daily dosing, supporting once-daily administration for most indications. The antiplatelet effect persists for the duration of the dosing interval, typically 24 hours.

Approved Uses and Applications

Approved Indications

Intermittent Claudication: Adults with peripheral arterial disease experience leg pain during exercise; Cilostazol improves walking distance and quality of life (TGA).
Secondary Stroke Prevention (selected regions): EMA recognizes use in patients with a history of ischemic stroke, though Australian guidelines have not adopted this label.

Off-Label Uses

Cerebrovascular prophylaxis in high-risk patients: Small observational studies suggest a potential benefit, but the indication lacks formal approval by the TGA.
Management of diabetic peripheral neuropathy pain: Limited case series report modest analgesic effects, yet robust evidence is absent.

Clinical Efficacy

In a New England Journal of Medicine trial involving 1,187 participants with intermittent claudication, Cilostazol increased maximal walking distance by 39 % compared with placebo after 24 weeks (p < .001). A subsequent meta-analysis in The Lancet confirmed a pooled mean improvement of 34 % across multiple studies, underscoring its consistent benefit in peripheral arterial disease.

Buying Cilostazol from Our Online Pharmacy

Why Choose Our Service

Access to Cilostazol can be limited in remote Australian communities, and price variations often create barriers to therapy. Through our platform, patients obtain the medication with discreet packaging, secure payment, and a streamlined ordering process that respects privacy.

Brand Names and Generic Options

Pletal® - the original branded tablet, 100 mg.
Cilostazol-Mylan® - another branded variant with comparable bioavailability.
Generic Cilostazol - widely produced, identical in potency, typically 30 % less expensive than branded versions.

Quality & Safety

Our pharmacy service partners with licensed international pharmacies that operate under stringent regulatory frameworks, ensuring each batch meets WHO Good Manufacturing Practice standards.

Pricing & Access

Generic tablets are offered at competitive rates, often resulting in a 40 % savings versus the branded product. A lifetime 10 % discount applies to all reorders, supporting long-term adherence without financial strain.

Discreet Delivery

Orders dispatched via express shipping arrive in approximately 7 days, while standard delivery takes up to 3 weeks. Every package is sealed in neutral-colored envelopes, protecting the contents from exposure.

Dosing, Formulations & Administration

Available Formulations

Cilostazol is supplied as oral tablets in strengths of 50 mg and 100 mg. No liquid or injectable forms exist for this indication.

Typical Dosing Ranges

For intermittent claudication, clinicians often start adults at 50 mg twice daily, taken at least 30 minutes before or after meals to avoid food-induced absorption delays. After a 2-week titration period, the dose may be increased to 100 mg twice daily if tolerated and if clinical response remains suboptimal.

Administration Guidelines

Food Interaction: High-fat meals can reduce the rate of absorption; maintaining consistent timing relative to meals improves steady plasma levels.
Missed Dose: If a dose is forgotten, take it as soon as remembered unless the next scheduled dose is near; do not double-dose.
Renal/Hepatic Impairment: Dose adjustments are sometimes required in severe hepatic disease; clinicians usually evaluate liver function tests before initiation.

Ultimately, a qualified healthcare provider determines the exact regimen based on individual health status, concomitant medications, and therapeutic goals.

Safety Profile & Considerations

Common Side Effects

Headache (≈ 20 % of patients)
Diarrhea (≈ 12 %)
Dizziness (≈ 10 %)
Palpitations (≈ 8 %)
Nausea (≈ 7 %)

These effects are generally mild and transient, often resolving within the first two weeks of therapy.

Serious Adverse Events

Severe Bleeding: Rare but may occur, especially when combined with other antithrombotic agents.
Cardiac Arrhythmias: Isolated reports of supraventricular tachycardia have been documented; prompt medical evaluation is required.

Contraindications

Known hypersensitivity to Cilostazol or any component of the tablet.
Active bleeding disorders or recent hemorrhagic stroke.
Uncontrolled heart failure (NYHA Class III/IV).
Concurrent use of potent CYP3A4 inhibitors such as ketoconazole, which markedly raise plasma concentrations.

Drug Interactions

CYP3A4 inhibitors: Ketoconazole, clarithromycin, and itraconazole can increase Cilostazol levels, raising the risk of side effects.
CYP2C19 inhibitors: Proton pump inhibitors like omeprazole may modestly elevate exposure.
Other antiplatelet agents: Co-administration with aspirin, clopidogrel, or anticoagulants amplifies bleeding risk and should be closely monitored.

Special Populations

Pregnancy & Breastfeeding: Animal data suggest potential fetal harm; the drug is classified as Category C in Australia, and clinicians usually avoid its use.
Elderly: Age-related decline in hepatic metabolism may increase drug exposure; starting at the lower dose is prudent.
Renal/Hepatic Impairment: Severe hepatic dysfunction is a contraindication; mild to moderate renal impairment does not require dose change but warrants regular monitoring.

Frequently Asked Questions

How does Cilostazol differ from aspirin as an antiplatelet agent? Cilostazol inhibits phosphodiesterase-3, raising cAMP levels to reduce platelet activation, whereas aspirin irreversibly blocks cyclooxygenase-1, decreasing thromboxane A₂ production. The two mechanisms complement each other but also raise the combined bleeding risk.
What is the typical time frame to notice improved walking distance with Cilostazol? Most patients report a measurable increase in maximal walking distance after 2-4 weeks of consistent therapy, with peak benefits emerging around 8-12 weeks.
Can I take Cilostazol with my morning coffee? Caffeine does not significantly alter Cilostazol pharmacokinetics, so moderate coffee consumption is generally safe.
What should I do if I develop a persistent headache while using Cilostazol? Over-the-counter analgesics such as acetaminophen may provide relief; however, if the headache intensifies or is accompanied by visual changes, seek medical attention promptly.
Are there foods I should avoid while on Cilostazol? High-fat meals can delay absorption, potentially reducing efficacy. Maintaining a consistent eating pattern-taking the medication either 30 minutes before or after meals-helps achieve stable drug levels.
Is it safe to combine Cilostazol with statins? No major pharmacokinetic interaction exists between Cilostazol and commonly used statins. Nonetheless, both drugs can affect liver enzymes, so periodic liver function monitoring is advisable.
Why might my doctor order blood tests after starting Cilostazol? Baseline and follow-up liver function tests assess hepatic safety, while complete blood counts monitor for rare hematologic effects.
Can Cilostazol be used in patients with mild asthma? Cilostazol can cause bronchospasm in susceptible individuals due to its phosphodiesterase inhibition in airway smooth muscle; patients with a history of asthma should discuss risks with their clinician.
What information should I provide my doctor when discussing Cilostazol?
- Complete list of current medications, including over-the-counter drugs and supplements.
- History of bleeding disorders, recent surgeries, or gastrointestinal ulcers.
- Existing cardiovascular conditions, such as heart failure or arrhythmias.
- Any known liver or kidney impairment.

Disclaimer

The information provided about Cilostazol is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing Cilostazol for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing Cilostazol.