What is Cilostazol: Uses, Dosage, Side Effects and More

Cilostazol is a prescription medication that helps improve blood flow in your legs and reduces pain when walking. It's specifically designed for people with a condition called intermittent claudication, where poor circulation causes leg pain during physical activity.

This medication belongs to a group called antiplatelet agents, which work by preventing blood cells from clumping together. Think of it as helping your blood flow more smoothly through narrowed arteries, much like adding oil to a squeaky hinge.

What is Cilostazol Used For?

Cilostazol is primarily prescribed to treat intermittent claudication, a condition where reduced blood flow to your legs causes pain, cramping, or tiredness during walking or exercise. This happens when arteries in your legs become narrowed or blocked, typically due to peripheral artery disease.

The medication helps increase the distance you can walk without pain by improving blood circulation. Many people find they can walk farther and climb stairs more easily after taking cilostazol regularly for several weeks.

In some cases, doctors may prescribe cilostazol to prevent blood clots or to help with other circulation problems. However, the primary and most well-studied use remains treating walking difficulties caused by poor leg circulation.

How Does Cilostazol Work?

Cilostazol works through two main mechanisms to improve your circulation. First, it prevents blood platelets from sticking together, which reduces the risk of clots forming in your already narrowed arteries.

Second, it helps relax and widen your blood vessels, allowing more blood to flow through them. This dual action is what makes cilostazol particularly effective for leg circulation problems.

The medication is considered moderately strong and typically takes 2-4 weeks of regular use before you notice significant improvement in your walking ability. It's not an immediate pain reliever, but rather works gradually to improve your overall circulation.

How Should I Take Cilostazol?

Take cilostazol exactly as your doctor prescribes, typically twice daily on an empty stomach. This means taking it at least 30 minutes before eating or 2 hours after a meal, as food can interfere with how well your body absorbs the medication.

Swallow the tablets whole with a full glass of water. Don't crush, chew, or break the tablets, as this can affect how the medication is released in your body.

Try to take your doses at the same times each day to maintain consistent levels in your bloodstream. Many people find it helpful to take cilostazol first thing in the morning and again in the early evening, well before dinner.

How Long Should I Take Cilostazol For?

Most people need to take cilostazol for at least 2-3 months to experience its full benefits. Your doctor will likely start you on a trial period to see how well you respond to the medication.

If cilostazol helps improve your walking distance and reduces leg pain, you may need to continue taking it long-term. The medication works best when taken consistently, and stopping it typically means your symptoms will return.

Your doctor will regularly review your progress and may adjust your treatment plan based on how well you're responding. Some people take cilostazol for years, while others may try it for several months to see if lifestyle changes alone can maintain their improvement.

What Are the Side Effects of Cilostazol?

Like all medications, cilostazol can cause side effects, though not everyone experiences them. Understanding what to expect can help you feel more prepared and know when to contact your healthcare provider.

The most common side effects are generally mild and often improve as your body adjusts to the medication:

• Headache (affects about 1 in 3 people)
• Diarrhea or loose stools
• Dizziness or lightheadedness
• Fast or irregular heartbeat
• Nausea or stomach upset
• Swelling in your legs, ankles, or feet
• Runny or stuffy nose

These common side effects usually become less bothersome after a few weeks of treatment. If they persist or interfere with your daily activities, talk with your doctor about adjusting your dose.

Less common but more serious side effects require immediate medical attention. While rare, these can include severe allergic reactions, unusual bleeding or bruising, chest pain, or signs of heart problems like severe shortness of breath.

Some people may experience unusual dreams, trouble sleeping, or mood changes. If you notice any bleeding that won't stop, black or bloody stools, or coughing up blood, contact your healthcare provider immediately.

Who Should Not Take Cilostazol?

Cilostazol isn't safe for everyone, and certain medical conditions make it unsuitable or require special precautions. Your doctor will carefully review your medical history before prescribing this medication.

You should not take cilostazol if you have congestive heart failure of any severity. The medication can worsen heart failure symptoms and may increase the risk of serious complications.

People with certain heart rhythm problems, severe kidney disease, or active bleeding disorders should avoid cilostazol. If you're pregnant or breastfeeding, discuss the risks and benefits with your healthcare provider, as the safety isn't fully established.

Tell your doctor about all medications you're taking, especially blood thinners, aspirin, or other antiplatelet drugs. Combining these medications can increase your risk of bleeding complications.

Cilostazol Brand Names

Cilostazol is available under several brand names, with Pletal being the most commonly prescribed in the United States. Other brand names include Pletoz and various generic formulations.

The generic versions contain the same active ingredient and work just as effectively as the brand-name versions. Your pharmacy may substitute a generic version unless your doctor specifically requests the brand name.

Whether you receive the brand name or generic version, the medication strength and effectiveness remain the same. Your insurance may have preferences for certain manufacturers, which could affect your out-of-pocket costs.

Cilostazol Alternatives

If cilostazol doesn't work well for you or causes troublesome side effects, several alternatives may help manage your circulation problems. The choice depends on your specific condition and overall health.

Pentoxifylline is another medication that improves blood flow and may help with walking difficulties. While it works differently than cilostazol, it can be effective for some people who can't tolerate cilostazol.

For some people, supervised exercise therapy programs can be remarkably effective for improving walking distance. These programs, often covered by insurance, involve guided exercise sessions that gradually build your stamina and circulation.

More severe cases might require medical procedures like angioplasty or bypass surgery to open blocked arteries. Your doctor can help determine the best approach based on your specific situation and overall health.

Is Cilostazol Better Than Pentoxifylline?

Both cilostazol and pentoxifylline help improve circulation, but they work through different mechanisms and have different strengths. Cilostazol is generally considered more effective for increasing walking distance in people with intermittent claudication.

Studies show that cilostazol typically provides greater improvement in walking ability compared to pentoxifylline. Many people can walk significantly farther without pain when taking cilostazol regularly.

However, pentoxifylline may be a better choice for people who can't take cilostazol due to heart problems, since it doesn't carry the same heart failure restrictions. Your doctor will consider your complete medical picture when choosing between these options.

The side effect profiles differ between the two medications, so if you experience problems with one, you might tolerate the other better. Sometimes doctors try both medications to see which works best for your individual situation.