Pletal Side Effects
Generic name: cilostazol
Note: This document contains side effect information about cilostazol. Some of the dosage forms listed on this page may not apply to the brand name Pletal.
Some side effects of Pletal may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to cilostazol: oral tablet
Along with its needed effects, cilostazol (the active ingredient contained in Pletal) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking cilostazol:More common
- Fast or irregular heartbeat
- Abnormal bleeding
- bloody or black tarry stools
- bruises and/or red spots on the skin
- nausea, heartburn, and/or indigestion (severe or continuing)
- stiff neck
- stomach pain, cramping, or burning (severe)
- swelling of the tongue
- vomiting of blood or material that looks like coffee grounds
- Abdominal or stomach pain
- area rash
- bleeding gums
- bleeding tendency
- blistering, peeling, loosening of skin
- blood in urine or stools
- blurred vision
- chest pain
- clay-colored stools
- cough or hoarseness
- coughing up blood
- dark urine
- difficult breathing
- fever with or without chills
- general feeling of tiredness or weakness
- headache, sudden and severe
- inability to speak
- irregular heartbeat
- itching of eyes
- itching of skin
- joint or muscle pain
- lab results that show problems with the liver
- 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 skin
- red, irritated eyes
- red skin lesions, often with a purple center
- shortness of breath
- skin rash
- slurred speech
- sores, ulcers, or white spots on lips or in mouth
- stomach pain
- swollen glands
- temporary blindness
- unpleasant breath odor
- unusual bleeding or bruising
- unusual tiredness or weakness
- weakness in arm and/or leg on one side of the body, sudden and severe
- weakness of part of body
- yellow eyes or skin
- dizziness or lightheadedness when getting up from a lying or sitting position
- fast or irregular heartbeat
- headache (severe)
Some side effects of cilostazol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More commonLess common
- Bone pain
- burning feeling in throat or chest
- difficulty in swallowing
- pain or stiffness in joints
- ringing or buzzing in ears
- swelling of face, fingers, and/or lower legs
- hot flushes
- Back pain
- increased cough
- pain or stiffness in muscles
- pounding heartbeat
- runny or stuffy nose
- sore throat
- swelling of arms or legs
For Healthcare Professionals
Applies to cilostazol: oral tablet
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.
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.
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.
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.
Musculoskeletal side effects have included back pain (7%), myalgia (3%), leg cramps (2%), and arthritis (2%).
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.
Dermatologic side effects have included rash in 2% of patients. Postmarketing reports have included pruritus and skin eruptions including Stevens-Johnson syndrome.
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.
Hematologic side effects have included postmarketing reports of thrombocytopenia, aplastic anemia, leukopenia, and bleeding tendencies.
Hepatic side effects have included postmarketing reports of jaundice, hepatic dysfunction and abnormal liver function tests.
Renal side effects have included postmarketing reports of increased BUN and hematuria.
More Pletal resources
- Pletal Prescribing Information (FDA)
- Pletal MedFacts Consumer Leaflet (Wolters Kluwer)
- Pletal Concise Consumer Information (Cerner Multum)
- Pletal Monograph (AHFS DI)
- Pletal Advanced Consumer (Micromedex) - Includes Dosage Information
- Cilostazol Professional Patient Advice (Wolters Kluwer)
- Cilostazol Prescribing Information (FDA)
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