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Coadministration of stronge.gketoconazoleand moderatee.gerythromycindiltiazem and grapefruit juiceCYP3A4 inhibitors can increase exposure to PletalReduce Pletal dose to 50 mg twice daily when coadministered with strong or moderate inhibitors of CYP3A4see Dosage and Administration2.2and Clinical Pharmacology12.3

In addition to reporting episodes of bleeding and easy bruisingpatients should be warned to promptly report any other signs which might also suggest the early development of blood dyscrasia such as pyrexia and sore throatA full blood count should be performed if infection is suspected or there is any other clinical evidence of blood dyscrasiaCilostazol should be discontinued promptly if there is clinical or laboratory evidence of haematological abnormalities.

Cases of thrombocytopenia or leukopenia progressing to agranulocytosis when Pletal was not immediately discontinued have been reportedAgranulocytosis is reversible on discontinuation of PletalMonitor platelets and white blood cell counts periodically.

Cilostazol is used to improve the symptoms of a certain blood flow problem in the legsintermittent claudicationCilostazol can decrease the muscle pain/cramps that occur during exercise/walkingClaudication pain is caused by too little oxygen getting to the musclesCilostazol can increase blood flow and the amount of oxygen that gets to the muscles.

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Pletal and several of its metabolites inhibit phosphodiesterase III activity and suppress cAMP degradation with a resultant increase in cAMP in platelets and blood vesselsleading to inhibition of platelet aggregation and vasodilationrespectively.

The transfer of cilostazol to breast milk has been reported in animal studiesThe excretion of cilostazol in human milk is unknownDue to the potential harmful effect in the newborn child breast fed by a treated motherthe use of Pletal is not recommended during breast feeding.

Cilostazol did not inhibit the metabolism of Rand S-warfarin after a single 25-mg dose of warfarin.

The total and unbound oral clearancesadjusted for body weightof cilostazol and its metabolites were not significantly different with respect to age50 to 80 yearsor gender.

Before having surgerytell your doctor or dentist about all the products you useincluding prescription drugsnonprescription drugsand herbal products

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