Cilostazol: Safety Profile and Clinical Management

Common Adverse Effects (ACC/AHA guideline)

• Diarrhea is a frequently reported adverse effect of cilostazol. 4
• Abnormal stools have been observed in patients receiving cilostazol. 2
• Palpitations may occur during cilostazol therapy. 2
• Dizziness is listed among the common side effects of cilostazol. 2
• Nausea can be experienced by patients taking cilostazol. 4
• Infections have been reported in clinical trials of cilostazol. 7

Pharmacologic Mechanism and Vascular Effects (ACC/AHA guideline)

• Cilostazol is a phosphodiesterase III inhibitor that produces vasodilation by increasing cyclic AMP levels. 1
• The drug induces greater vasodilation in femoral arterial beds compared with vertebral, carotid, or superior mesenteric arteries. 1

Clinical Monitoring and Discontinuation Threshold (ACC/AHA guideline)

• Headache may be severe enough to require discontinuation in roughly 2–4 % of patients receiving the standard 100 mg twice‑daily dose of cilostazol. 1
• Patients should be reassessed for tolerance after 2–4 weeks of therapy and the benefit of continued treatment evaluated at 3–6 months to decide on long‑term use. 7