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Drug Interactions between cilostazol and turmeric

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

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Interactions between your drugs

Moderate

cilostazol turmeric

Applies to: cilostazol and turmeric

MONITOR: Turmeric may potentiate the bleeding risk associated with drugs that interfere with platelet function or coagulation. In vitro data suggest that curcumin, an active constituent of turmeric, may inhibit platelet-activating factor and platelet aggregation. Isolated case reports have also described increases in INR following initiation of turmeric-containing products in patients treated with a vitamin K antagonist such as warfarin. However, pharmacologic effects of turmeric preparations may be highly variable due to inconsistencies in formulation and potency of commercial herbal products.

MANAGEMENT: Caution is advised when turmeric-containing products are used concomitantly with drugs that affect hemostasis such as anticoagulants, antiplatelet agents, nonsteroidal anti-inflammatory drugs, serotonin reuptake inhibitors, and thrombolytic agents. Clinical and laboratory observation for hematologic complications is recommended.

References (4)
  1. Heck AM, DeWitt BA, Lukes AL (2000) "Potential interactions between alternative therapies and warfarin." Am J Health Syst Pharm, 57, 1221-7; quiz 1228-30
  2. Abebe W (2002) "Herbal medication: potential for adverse interactions with analgesic drugs." J Clin Pharm Ther, 27, p. 391-401
  3. Yang X, Thomas DP, Zhang X, et al. (2006) "Curcumin inhibits platelet-derived growth factor-stimulated vascular smooth muscle cell function and injury-induced neointima formation." Arterioscler Thromb Vasc Biol, 26, p. 85-90
  4. New Zealand Medicines and Medical Devices Safety Authority (2022) Medsafe Monitoring Communication: Beware turmeric/curcumin containing products can interact with warfarin. https://medsafe.govt.nz/safety/EWS/2018/Turmeric.asp

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

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.

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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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