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Drug Interactions between cilostazol and epoprostenol

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

epoprostenol cilostazol

Applies to: epoprostenol and cilostazol

MONITOR: Prostacyclin/prostacyclin analogs (e.g., epoprostenol, iloprost, treprostinil) inhibit platelet aggregation and may theoretically potentiate the risk of bleeding in patients treated with other agents that affect hemostasis such as anticoagulants, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or agents that commonly cause thrombocytopenia. In clinical trials for pulmonary hypertension, patients received concomitant anticoagulants and/or nonsteroidal anti-inflammatory agents without evidence of increased bleeding.

MANAGEMENT: Caution is advised if prostacyclin and prostacyclin analogs are used in combination with other drugs that affect hemostasis. Close clinical and laboratory observation for hemorrhagic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References

  1. (2001) "Product Information. Flolan (epoprostenol)." Glaxo Wellcome
  2. (2002) "Product Information. Remodulin (treprostinil)." United Therapeutics Corporation
  3. (2005) "Product Information. Ventavis (iloprost)." Actelion Pharmaceuticals US Inc

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Drug and food interactions

Moderate

cilostazol food

Applies to: cilostazol

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of cilostazol. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.

MANAGEMENT: Until more information is available, the manufacturer recommends avoiding consumption of grapefruit juice during cilostazol therapy. Orange juice is not expected to interact with cilostazol.

References

  1. (2001) "Product Information. Pletal (cilostazol)." Otsuka American Pharmaceuticals Inc

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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