Cilostazol is a selective inhibitor of phosphodiesterase-III with antiplatelet, antithrombotic and vasodilating properties. Cilostazol improves the flow of blood through blood vessels and is used to reduce leg pain caused by poor circulation.

Cilostazol dosage reduction should be considered during coadministration of cilostazol and CYP3A4 or CYP2C19 inhibitors. Genetic variations in these enzymes can also affect cilostazol clearance and the risk of side effects.

Cilostazol should only be used for intermittent claudication when lifestyle changes (including smoking cessation and exercise programmes) and other appropriate interventions alone have not produced adequate benefit. Treatment should only be started by physicians experienced in the management of intermittent claudication, and should be reviewed after three months. Treatment should be stopped in patients who have not shown clinically relevant benefit. Cilostazol should not be given to patients who have unstable angina or who have had myocardial infarction or a coronary intervention (PCI) within the last six months, nor to those with a history of severe tachyarrhythmia.

• https://www.ncbi.nlm.nih.gov/pubmed/26426352
• https://www.ncbi.nlm.nih.gov/pubmed/19516253
• https://academic.oup.com/ehjcvp/article/8/1/85/6151754