Pletal (cilostazol) is a prescription medication specifically developed to improve walking distance in individuals suffering from intermittent claudication, a symptom of peripheral artery disease. By inhibiting phosphodiesterase III, it enhances blood flow to the legs, reducing pain and cramping during physical activity. This vasodilator and antiplatelet agent offers a well-researched, non-surgical option for increasing mobility and quality of life. Clinical studies demonstrate its efficacy in helping patients walk farther with less discomfort, making it a cornerstone in the management of this circulatory condition.

Features

• Active ingredient: Cilostazol 50 mg or 100 mg
• Mechanism: Selective phosphodiesterase III inhibitor
• Formulation: Oral tablets
• Onset of action: Noticeable improvement within 4–12 weeks
• Half-life: Approximately 11–13 hours
• Metabolism: Hepatic, primarily via CYP3A4 and CYP2C19
• Excretion: Urinary and fecal

Benefits

• Significantly increases pain-free and maximal walking distances
• Improves overall functional capacity and mobility in patients with claudication
• Reduces leg pain and cramping associated with peripheral artery disease
• Enhances quality of life by enabling greater participation in daily activities
• Provides antiplatelet effects which may help reduce thrombotic events
• Offers a pharmacologic alternative to surgical intervention in select cases

Common use

Pletal is primarily indicated for the reduction of symptoms of intermittent claudication, a condition characterized by pain, cramping, or weakness in the legs during physical activity due to inadequate blood flow. It is used in patients with peripheral artery disease who do not respond adequately to exercise and lifestyle modifications alone. The medication is typically prescribed when symptoms significantly limit mobility and quality of life, and when surgical revascularization is not appropriate or desired. It is not intended to cure peripheral artery disease but rather to manage its symptomatic manifestations.

Dosage and direction

The recommended dosage of Pletal is 100 mg taken orally twice daily, approximately 30 minutes before or 2 hours after breakfast and dinner. For patients who may not tolerate this dose, a reduced dosage of 50 mg twice daily may be prescribed. Treatment should be continued for at least 3 months to assess effectiveness, though many patients require longer-term therapy. Dosage adjustments are necessary in patients taking concomitant medications that inhibit CYP3A4 or CYP2C19 enzymes. The medication should be taken at consistent times each day to maintain stable blood levels.

Precautions

Patients should be monitored for potential cardiovascular effects, particularly those with history of heart failure. Regular assessment of bleeding parameters is advised due to antiplatelet effects. Hepatic impairment requires dosage adjustment or avoidance. Caution is warranted in patients with severe renal impairment. Ophthalmologic examinations are recommended as visual disturbances have been reported. Patients should be advised about the increased risk of bleeding and instructed to report unusual bruising or bleeding. Blood pressure and heart rate should be monitored periodically during treatment.

Contraindications

Pletal is contraindicated in patients with known hypersensitivity to cilostazol or any component of the formulation. It must not be used in patients with congestive heart failure of any severity class. Contraindications include pre-existing hematologic disorders or active pathological bleeding. Concurrent use with strong inhibitors of CYP3A4 or CYP2C19 is prohibited. The medication is not recommended for patients with severe hepatic impairment. It should not be administered to patients with known or suspected pregnancy.

Possible side effects

• Headache (27-34% of patients)
• Diarrhea (12-19%)
• Abnormal stools (12-15%)
• Palpitations (10-14%)
• Dizziness (9-12%)
• Pharyngitis (7-10%)
• Infection (6-8%)
• Peripheral edema (4-7%)
• Tachycardia (3-5%)
• Rhinitis (2-4%)
• Nausea (3-5%)
• Flatulence (2-3%)
• Bleeding complications (1-2%)
• Visual disturbances (<1%)

Drug interaction

Pletal interacts significantly with medications that inhibit CYP3A4 and CYP2C19 enzymes. Strong inhibitors such as ketoconazole, itraconazole, erythromycin, clarithromycin, and diltiazem may increase cilostazol concentrations. Omeprazole and other CYP2C19 inhibitors may also elevate drug levels. Concurrent use with other antiplatelet agents or anticoagulants increases bleeding risk. Aspirin and clopidogrel may potentiate antiplatelet effects. Grapefruit juice should be avoided due to CYP3A4 inhibition. Dosage adjustments are necessary when co-administering with these medications.

Missed dose

If a dose of Pletal is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed one. Consistency in dosing is important for maintaining therapeutic effects, so establishing a routine is recommended. If multiple doses are missed, patients should contact their healthcare provider for guidance.

Overdose

Symptoms of Pletal overdose may include severe headache, diarrhea, hypotension, tachycardia, and cardiac arrhythmias. In cases of significant overdose, bleeding complications may occur due to its antiplatelet effects. Management should include supportive care with monitoring of vital signs and cardiac function. Gastric lavage may be considered if ingestion was recent. Activated charcoal may be administered. There is no specific antidote for cilostazol overdose. Hemodialysis is not expected to be effective due to high protein binding. Symptomatic treatment should be provided as needed.

Storage

Pletal tablets should be stored at room temperature between 15-30°C (59-86°F) in their original container. The medication must be kept tightly closed and protected from light and moisture. It should be stored out of reach of children and pets. Do not store in bathrooms or other areas with high humidity. Unused medication should be properly disposed of according to local regulations once expired or no longer needed. Do not flush medications down the toilet unless specifically instructed to do so.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Pletal is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual results may vary. Patients should consult their physician for proper diagnosis and treatment recommendations. The information provided here is not exhaustive and does not replace the official prescribing information. Always follow your healthcare provider’s instructions regarding medication use.

Reviews

Clinical studies demonstrate that approximately 40-50% of patients experience significant improvement in walking distance with Pletal therapy. Many patients report reduced leg pain and improved quality of life after 12 weeks of treatment. Some users note side effects such as headache and palpitations, which often diminish with continued use. Healthcare providers generally consider it an effective option for motivated patients who adhere to the prescribed regimen and accompanying lifestyle modifications. Long-term users frequently report sustained benefits in mobility and symptom management when combined with regular exercise programs.