Cilostazol Tablet: Uses, Dosage & Side Effects in Pakistan

Cilostazol Tablet (Pletaal / Pletal) Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info (Mukhtasir Maloomat)

2. What is Cilostazol? (Cilostazol kya hai)

Cilostazol (brand: Pletaal, Pletal) is an antiplatelet and vasodilator medicine. It selectively blocks the PDE3 (phosphodiesterase type 3) enzyme, affecting both platelets and blood vessels. In peripheral arterial disease (PAD) — where the leg arteries become narrowed — cilostazol reduces pain while walking (intermittent claudication) and increases walking distance. Meta-analyses show 40–50% greater walking improvement over placebo.

IMPORTANT: Cilostazol is ABSOLUTELY contraindicated in heart failure — at any degree. This is a class effect of PDE3 inhibitors that increases mortality in heart failure (milrinone, vesnarinone trials).

3. Uses (Fayde / Kis kaam aata hai)

• Peripheral Arterial Disease (PAD) — Intermittent Claudication: pain, fatigue or tingling in the legs while walking when arteries are narrowed — cilostazol improves walking distance by increasing blood flow
• Post-Stroke / TIA Secondary Prevention: adjunct secondary prevention after stroke or TIA — particularly used in South/East Asian patients per certain Asian guidelines
• Coronary Stent Restenosis Prevention: to prevent stent re-narrowing in selected Asian cardiology protocols (anti-proliferative effect)

4. Who Should Take (Kin ko di jati hai)

• Patients with PAD who experience leg pain while walking
• Patients who need secondary prevention after stroke or TIA (doctor-decided)
• Patients who have had a coronary stent and for whom the doctor has specifically prescribed cilostazol

5. When NOT to Take (Kab bilkul nahi leni)

• Heart Failure — CONTRAINDICATED
• Active bleeding or haemorrhagic disorder
• Haemorrhagic stroke history
• Allergy to cilostazol
• Pregnancy

6. Dosage (Kitni leni hai)

• 100mg twice daily — take 30 minutes before or 2 hours after meals
• If a CYP3A4/2C19 inhibitor (such as omeprazole, ketoconazole, erythromycin) is co-prescribed, reduce to 50mg twice daily — drug interaction raises levels

• Not established in children — consult your doctor

• 200mg/day (100mg BD) — do not exceed this

• Take it as soon as you remember. If the next dose is close, skip the missed dose. Never take a double dose.

7. How to Take (Kaise leni hai)

• Take 30 minutes before or 2 hours after meals
• Do not take with grapefruit juice — it reduces absorption
• Swallow with water

8. Best Time (Kab leni chahiye)

• Morning dose — before meals
• Evening dose — before meals or 2 hours after meals
• Maintain a routine — take at the same time each day

9. Empty Stomach or After Food (Khali pait ya khane ke baad)

It is essential to take this medicine 30 minutes before or 2 hours after meals — taking it with food can significantly reduce absorption. Avoid grapefruit juice.

10. Warnings (Ihtiyat)

Cilostazol is ABSOLUTELY PROHIBITED in heart failure — at any degree. PDE3 inhibition increases cardiac inotropy, which raises the mortality risk in heart failure. This is a class effect (milrinone, vesnarinone trials).

• There is a risk of arrhythmia — if rapid or irregular heartbeat is noticed, see a doctor immediately
• Caution in uncontrolled tachycardia

• Bleeding risk increases when taken with anticoagulants or antiplatelet drugs
• Inform your doctor before surgery

• Reduce dose to 50mg BD when taken with CYP3A4/2C19 inhibitors

11. Precautions (Ahm Ehtiyaat)

• Store below 30°C
• Keep away from direct sunlight and moisture
• Keep out of the reach of children

12. Side Effects (Nuksanat)

• Headache
• Diarrhoea
• Palpitations / awareness of heartbeat
• Dizziness
• Rhinitis (nasal congestion)
• Peripheral oedema
• Tachycardia (fast heart rate)

• Cardiac arrhythmias / tachyarrhythmias — see a doctor immediately
• Thrombocytopenia — low platelets (rare) — see a doctor if unusual bruising or bleeding occurs
• Agranulocytosis (very rare) — see a doctor if signs of infection, fever, or mouth sores appear
• Hepatic failure (rare) — see a doctor IMMEDIATELY if yellowing of eyes/skin or dark urine occurs

13. Drug Interactions (Dawaon ke sath reaction)

• CYP3A4 inhibitors (ketoconazole, erythromycin, diltiazem, fluconazole): cilostazol levels increase — reduce dose to 50mg BD
• CYP2C19 inhibitors (omeprazole, lansoprazole, esomeprazole): levels increase — monitor or use 50mg BD
• Antiplatelet/anticoagulant drugs (aspirin, clopidogrel, warfarin, heparin): additive bleeding risk — use under doctor's supervision
• Grapefruit juice: reduces absorption — avoid

14. When to See Doctor (Kab doctor ke paas jayein)

• Chest pain or irregular/rapid heartbeat
• Unusual bleeding — nosebleed, dark urine or stool, skin marks
• Severe headache (migraine-type — vasodilatory)
• Worsening leg pain or pain at rest
• Yellowing of eyes or skin

15. Alternatives (Sasti Dusri Dawaein)

16. Price in Pakistan (Price kitni hai)

17. FAQs (Aksar Poochay Jane Walay Sawalat)

Q: What is cilostazol used for?

A: Cilostazol is used in peripheral arterial disease (PAD) to improve blood supply to the legs. It reduces pain while walking (claudication) and can increase walking distance by 40–50%. In some cases it is also used for stroke prevention.

Q: How does cilostazol help with leg pain?

A: Cilostazol blocks PDE3 enzyme, thinning platelets and dilating blood vessels. This delivers more oxygen and blood to the leg muscles — reducing pain while walking.

Q: What are the side effects of cilostazol?

A: The most common side effect is headache (from vasodilation) — usually controlled with paracetamol. Diarrhoea, palpitations, and dizziness may also occur. Serious side effects include arrhythmia and (rare) liver problems.

Q: What is the price of cilostazol in Pakistan?

A: Price varies by pharmacy and pack size. Confirm the updated price at your local pharmacy or dawaai.pk.

Q: Why should cilostazol not be taken in heart disease?

A: In heart failure, PDE3 inhibitors — the class to which cilostazol belongs — increase cardiac inotropy, which raises mortality. Clinical trials have demonstrated this. Therefore cilostazol is strictly contraindicated in heart failure.

18. Medical Review (Medical Jaiza)

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer (Zaroori Tanbeeh)

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.