Cilostazol Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Intermittent Claudication

100 mg orally twice a day administered at least 30 minutes before or 2 hours after breakfast and dinner.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Cilostazol is extensively metabolized in the liver by the cytochrome P450 enzyme system, therefore, patients with significant hepatic dysfunction should receive 50 mg orally twice a day.

Dose Adjustments

Because of cytochrome P450 (CYP450) enzyme interactions, the dose of cilostazol should be lowered to 50 mg orally twice a day during periods of coadministration with CYP450 enzyme inhibitors such as azole antifungals, macrolide antibiotics, and proton pump inhibitors. In addition, patients should avoid consuming grapefruit juice while receiving cilostazol therapy.

Precautions

Cilostazol and several of its metabolites are phosphodiesterase III inhibitors. Several drugs with this pharmacologic effect have caused decreased survival when compared to placebo in patients with class III-IV congestive heart failure (CHF). Cilostazol is contraindicated in patients with CHF of any severity.

Cilostazol reversibly inhibits platelet aggregation and is contraindicated in patients with active pathologic bleeding (i.e., peptic ulcer, intracranial bleeding).

Cilostazol should be used with caution in patients at risk of bleeding and in those receiving an antiplatelet agent.

Cilostazol should be used with caution in patients with pre-existing hematologic disorders (i.e., thrombocytopenia).

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available; however, it is unlikely that cilostazol is removed appreciably by dialysis because of its high protein binding.

Other Comments

Cilostazol should be taken 30 minutes before or two hours after breakfast and dinner.

Although some patients may notice clinical improvement in as few as 2 or 3 weeks of treatment, others may require up to 12 weeks of therapy before a beneficial effect is experienced.

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