CILOSTAZOL

Cilostazol 100mg, Oral tablet

Food

· Severity: Severe

· Notes for Consumers: Do not take Cilostazol with Food. Take Cilostazol on an empty stomach, at least one-half hour before or 2 hours after a meal. Food (especially high-fat food) can increase the amount of Cilostazol in the blood, and possibly increase the chance of side effects from Cilostazol. Side effects of Cilostazol may include: diarrhea, dizziness, edema (such as swelling of the ankles or legs), headache, stomach pain, or upset stomach. Contact your prescriber if you have palpitations, chest pain, or a change in your heartbeat (such as a fast or irregular heartbeat).while taking Cilostazol.

· Notes for Professionals: Coadministration with food increases both the AUC and the Cmax of cilostazol, particularly if the meal has a high fat content. Cilostazol is recommended to be administered on an empty stomach, at least one-half hour before or two hours after food.

Cilostazol 100mg, Oral tablet

Grapefruit juice

· Severity: Major

· Notes for Consumers: Use caution when taking Cilostazol with Grapefruit or Grapefruit juice. Taking Grapefruit juice with Cilostazol can increase the amount of Cilostazol in the blood, and possibly increase the chance of side effects from Cilostazol. Side effects of Cilostazol may include: diarrhea, dizziness, edema (such as swelling of the ankles or legs), headache, stomach pain, or upset stomach. Contact your prescriber if you have palpitations, chest pain, or a change in your heartbeat (such as a fast or irregular heartbeat) while taking Cilostazol.

· Notes for Professionals: While the effects have not been systematically evaluated, grapefruit juice may inhibit cilostazol metabolism by inhibiting cytochrome P450 3A4 in enterocytes. Grapefruit juice inhibits the cytochrome P-450 3A4 isozyme in the gut wall. Grapefruit juice contains furanocoumarins that are metabolized by CYP3A4 to reactive intermediates. These intermediates form a covalent bond to the active site of the CYP3A4 enzyme, causing irreversible inactivation (mechanism-based inhibition). Consequently, CYP3A4 activity in the gut wall is inhibited until de novo synthesis returns the enzyme to its previous level. Grapefruit juice increases the Cmax of cilostazol by about 50%, but has no effect on cilostazol AUC. The clinical significance of the interaction is unknown. It is possible that cilostazol induced side effects could be increased in some individuals.

Cilostazol 100mg, Oral tablet

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. When used together, your medication may not work as well for you.

· Notes for Professionals: Tobacco smoking appears to decrease cilostazol serum concentrations by roughly 20%. There were no statistically significant differences in absolute claudication distance (ACD) at the end of cilostazol treatment during clinical trials in those patients with peripheral arterial disease who were smokers versus those who were not. However, it is unknown if tobacco smoking would contribute to a decreased clinical response to cilostazol when the drug is administered for other uses or when the clinical response to cilostazol is measured by parameters other than ACD. Given the adverse effects that tobacco smoking may have on the peripheral vasculature, patients taking cilostazol should be advised not to smoke tobacco.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>