Usual Adult Dose for Intermittent Claudication
100 mg orally twice a day at least 30 minutes before or 2 hours after breakfast and dinner
Comments:
- Patients may respond as early as 2 to 4 weeks after initiation of therapy, but treatment for up to 12 weeks may be required before a beneficial effect is experienced.
- If symptoms remain unimproved after 3 months, discontinue this drug.
Use: Reduction of symptoms of intermittent claudication, as demonstrated by an increased walking distance.
Renal Dose Adjustments
No adjustment recommended.
Liver Dose Adjustments
Mild liver dysfunction: No adjustment recommended.
Moderate to severe liver dysfunction: Dosage adjustment(s) may be required; however, no specific guidelines have been suggested.
Dose Adjustments
Coadministration with strong or moderate inhibitors of CYP450 3A4 (e.g., diltiazem, erythromycin, itraconazole, ketoconazole) or inhibitors of CYP450 2C19 (e.g., fluconazole, omeprazole, ticlopidine): Reduce cilostazol dose to 50 mg orally twice a day
Precautions
US BOXED WARNING:
- CONTRAINDICATED IN HEART FAILURE PATIENTS: This drug is contraindicated in patients with heart failure of any severity. This drug and several of its metabolites are inhibitors of phosphodiesterase III. Several drugs with this pharmacologic effect have caused decreased survival compared to placebo in patients with class III to IV heart failure.
CONTRAINDICATIONS:
- Hypersensitivity (e.g., anaphylaxis, angioedema) to the active component or any of the ingredients
- Heart failure of any severity
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Monitoring:
- Cardiovascular: Monitor for the development of a new systolic murmur or cardiac symptoms.
- Hematologic: Platelets and white blood cell counts periodically.
Patient advice:
- Advise patients to promptly report any episode of bleeding or easy bruising or any other signs which might suggest early development of blood dyscrasia (e.g., pyrexia, sore throat).
- This drug may cause drowsiness; exercise caution before driving or operating machinery.
