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Pletal Side Effects

Generic Name: cilostazol

Note: This page contains side effects data for the generic drug cilostazol. It is possible that some of the dosage forms included below may not apply to the brand name Pletal.

It is possible that some side effects of Pletal may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to cilostazol: oral tablet

As well as its needed effects, cilostazol (the active ingredient contained in Pletal) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking cilostazol, check with your doctor immediately:

More common
  • Fast or irregular heartbeat
  • fever
Less common
  • Abnormal bleeding
  • bloody or black tarry stools
  • bruises or red spots on the skin
  • fainting
  • nausea, heartburn, or indigestion (severe or continuing)
  • nosebleeds
  • stiff neck
  • stomach pain, cramping, or burning (severe)
  • swelling of the tongue
  • vomiting of blood or material that looks like coffee grounds
Incidence not known
  • Abdominal or stomach pain
  • area rash
  • bleeding gums
  • bleeding tendency
  • blistering, peeling, loosening of the skin
  • blood in the urine or stools
  • blurred vision
  • chest pain
  • chills
  • clay-colored stools
  • confusion
  • cough or hoarseness
  • coughing up blood
  • dark urine
  • diarrhea
  • difficulty with breathing
  • drowsiness
  • fever with or without chills
  • general feeling of tiredness or weakness
  • headache, sudden and severe
  • inability to speak
  • itching of the eyes
  • itching of the skin
  • joint or muscle pain
  • light-colored stools
  • loss of appetite
  • loss of consciousness
  • lower back or side pain
  • nausea and vomiting
  • painful or difficult urination
  • pinpoint red spots on the skin
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • seizures
  • skin rash
  • slurred speech
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain
  • swollen glands
  • temporary blindness
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weakness in the arm or leg on one side of the body, sudden and severe
  • weakness of part of the body
  • yellow eyes or skin

If any of the following symptoms of overdose occur while taking cilostazol, get emergency help immediately:

Symptoms of overdose
  • Diarrhea
  • dizziness or lightheadedness when getting up from a lying or sitting position
  • fast or irregular heartbeat
  • headache (severe)

Some cilostazol side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Back pain
  • dizziness
  • gas
  • headache
  • increased cough
  • pain or stiffness in the muscles
  • pounding heartbeat
  • runny or stuffy nose
  • sore throat
  • swelling of the arms or legs
Less common
  • Bone pain
  • burning feeling in the throat or chest
  • difficulty with swallowing
  • hives
  • pain or stiffness in the joints
  • ringing or buzzing in the ears
  • swelling of the face, fingers, or lower legs
Incidence not known
  • Bruising
  • hot flushes
  • pain

For Healthcare Professionals

Applies to cilostazol: oral tablet

Nervous system

Nervous system side effects have commonly included headache (34%) resulting in discontinuation in 3.5% of patients. Dizziness (10%) and vertigo (2%) have also been reported. Other less frequently reported side effects have included asthenia, hyperesthesia, and paresthesia. Postmarketing reports have included intracranial hemorrhage, cerebral hemorrhage, cerebrovascular accident, extradural hematoma and subdural hematoma.[Ref]


An increase in ventricular premature beats and nonsustained ventricular tachycardia have been seen in Holter monitored patients. Cardiovascular damage including endocardial hemorrhage, left ventricular fibrosis, and necrosis of smooth muscle in coronary arteries has been demonstrated in dogs after 52 weeks of cilostazol (the active ingredient contained in Pletal) administration.

In the AT-BAT study, one patient died during a bradycardic episode 46 hours after a successful PCI, another patient required surgical revascularization, and one patient experienced no reflow requiring a temporary intra-aortic balloon.[Ref]

Cardiovascular side effects have included palpitations (10%) and tachycardia (4%). Peripheral edema has been reported in 7% of patients, and hypertension and angina pectoris have been reported in 2% of patients. Atrial fibrillation, atrial flutter, cerebral infarct, cerebral ischemia, congestive heart failure, heart arrest, hemorrhage, hypotension, myocardial infarction, myocardial ischemia, nodal arrhythmia, postural hypotension, supraventricular tachycardia, syncope, varicose vein, vasodilation, ventricular extrasystoles, and ventricular tachycardia have also been reported. Post marketing reports have included torsades de pointes and QTc prolongation in patients with cardiac disorders, e.g. complete atrioventricular block, cardiac failure and bradyarrhythmia. In these reports cilostazol was used "off label" due to its positive chronotropic action.[Ref]


Gastrointestinal side effects have included diarrhea (19%), nausea (7%), dyspepsia (6%), abdominal pain (5%), flatulence (3%) and vomiting (2%). Other gastrointestinal side effects have included anorexia, cholelithiasis, colitis, duodenal ulcer, duodenitis, esophageal hemorrhage, esophagitis, increased GGT, gastritis, gastroenteritis, gum hemorrhage, hematemesis, melena, peptic ulcer, periodontal abscess, rectal hemorrhage, stomach ulcer, and tongue edema.[Ref]


Musculoskeletal side effects have included back pain (7%), myalgia (3%), leg cramps (2%), and arthritis (2%).[Ref]


Respiratory side effects have included pharyngitis (10%), rhinitis (7%), increased cough (4%), dyspnea (2%), and bronchitis (2%). Postmarketing reports have included pulmonary hemorrhage and interstitial pneumonia.[Ref]


Dermatologic side effects have included rash in 2% of patients. Postmarketing reports have included pruritus and skin eruptions including Stevens-Johnson syndrome.[Ref]


In the AT-BAT study, one patient who did not undergo PCI had major bleeding during CABG on the day following angiography, nine patients had minor bleeding (mostly due to access site bleeding), and two patients developed moderate thrombocytopenia.[Ref]

Hematologic side effects have included postmarketing reports of thrombocytopenia, aplastic anemia, leukopenia, and bleeding tendencies.[Ref]


Hepatic side effects have included postmarketing reports of jaundice, hepatic dysfunction and abnormal liver function tests.[Ref]


Renal side effects have included postmarketing reports of increased BUN and hematuria.[Ref]


1. Pratt CM "Analysis of the cilostazol safety database." Am J Cardiol 87 (2001): d28-33

2. Ohashi S, Iwatani Y, Hyakuna Y, Morioka Y "Thermographic evaluation of the hemodynamic effect of the antithrombotic cilostazol in peripheral arterial occclusion." Arzneimittelforschung 35 (1985): 1203-8

3. Atarashi H, Endoh Y, Saitoh H, Kishida H, Hayakawa H "Chronotropic effects of cilostazol, a new antithrombotic agent, in patients with bradyarrhythmias." J Cardiovasc Pharmacol 31 (1998): 534-9

4. "Product Information. Pletal (cilostazol)." Otsuka American Pharmaceuticals, Rockville, MD.

5. Niki T, Mori H "Phase I study of cilostazol. Safety evaluation at increasing single doses in healthy volunteers." Arzneimittelforschung 35 (1985): 1173-85

6. Money SR, Herd JA, Isaacsohn JL, Davidson M, Cutler B, Heckman J, Forbes WP "Effect of cilostazol on walking distances in patients with intermittent claudication caused by peripheral vascular disease." J Vasc Surg 27 (1998): 267-74;disc. 274-5

7. Sekiya M, Funada J, Watanabe K, Miyagawa M, Akutsu H "Effects of probucol and cilostazol alone and in combination on frequency of poststenting restenosis." Am J Cardiol 82 (1998): 144-7

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.