Home Drug Guide Cilostazol

Drug Guide

Generic Name

Cilostazol

Brand Names Pletal

Classification

Therapeutic: Antiplatelet Agent and Vasodilator

Pharmacological: Phosphodiesterase III Inhibitor

FDA Approved Indications

  • Intermittent Claudication due to Peripheral Arterial Disease

Mechanism of Action

Cilostazol inhibits phosphodiesterase III, leading to increased levels of cyclic AMP, which causes vasodilation and inhibits platelet aggregation, improving blood flow in peripheral arteries.

Dosage and Administration

Adult: 100 mg twice daily, 30 minutes before or 2 hours after meals

Pediatric: Not approved for pediatric use

Geriatric: Use with caution; adjust dose based on tolerability and risk factors

Renal Impairment: Adjust dose based on severity of impairment; typically, use with caution and monitor closely

Hepatic Impairment: Use with caution; no specific dose adjustment established

Pharmacokinetics

Absorption: Well absorbed orally

Distribution: Widely distributed, crossing the placenta and into breast milk

Metabolism: Extensively metabolized in the liver via CYP3A4 and CYP2C19

Excretion: Primarily in urine as metabolites, small amount as unchanged drug in feces

Half Life: 11-13 hours

Contraindications

  • Heart failure of NYHA Class III or IV
  • Active bleeding or bleeding disorder

Precautions

  • Use cautiously in patients at risk for bleeding, with hepatic impairment, or with a history of syncope

Adverse Reactions - Common

  • Headache (Common)
  • Diarrhea (Common)
  • Dizziness (Common)
  • Tachycardia (Common)

Adverse Reactions - Serious

  • Bleeding (Rare)
  • Thrombocytopenia (Rare)
  • Arrhythmias (Rare)

Drug-Drug Interactions

  • Concurrent use with other antiplatelet agents or anticoagulants increases bleeding risk.

Drug-Food Interactions

  • No significant food interactions reported.

Drug-Herb Interactions

  • Potential increased bleeding with garlic, ginseng, ginkgo.

Nursing Implications

Assessment: Monitor for signs of bleeding, cardiovascular status, and blood pressure.

Diagnoses:

  • Risk for bleeding
  • Ineffective tissue perfusion

Implementation: Administer as prescribed, educate patient on bleeding precautions, monitor liver function.

Evaluation: Assess for reduced claudication symptoms, monitor for adverse effects and signs of bleeding.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report signs of bleeding (bruising, bleeding gums, blood in stool).
  • Inform about possible side effects like headache and dizziness.

Special Considerations

Black Box Warnings:

  • Increased risk of cardiovascular events in patients with heart failure.

Genetic Factors: No specific genetic considerations noted.

Lab Test Interference: May cause false elevations in uric acid levels.

Overdose Management

Signs/Symptoms: Dizziness, tachycardia, hypotension, bleeding

Treatment: Supportive care, manage bleeding if present, activated charcoal if within an hour of ingestion, no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable in original container, protect from moisture and light.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.