Generic Cilostazol

Introduction

Cilostazol is a phosphodiesterase‑3 (PDE‑3) inhibitor that is primarily prescribed to improve walking distance in people with peripheral arterial disease (PAD) affecting the lower limbs. In the United Kingdom it is classified under the “General health” medication group because it addresses circulatory impairment rather than a specific disease organ system. The active compound, Cilostazol, is supplied both as a branded product (most commonly known as Pletal) and as a generic tablet. Its main therapeutic aim is to reduce the frequency of intermittent claudication—painful muscle cramping that occurs during exertion—by enhancing blood flow to the affected limbs.

The drug is manufactured by several licensed pharmaceutical companies; the original brand was developed by Pfizer. Since the patent expiry, numerous generic manufacturers have produced Cilostazol tablets that meet the same quality standards required by the Medicines and Healthcare products Regulatory Agency (MHRA). In addition to its primary indication, Cilostazol has demonstrated secondary benefits such as platelet aggregation inhibition, which may be relevant for patients with mixed atherosclerotic risk profiles.

What is Cilostazol?

Cilostazol is the generic version of Pletal, containing the same active compound Cilostazol. It belongs to the class of phosphodiesterase‑3 inhibitors and is formulated as an immediate‑release tablet for oral administration. The medication is marketed for the treatment of intermittent claudication associated with peripheral arterial disease. Our online pharmacy provides this generic alternative as a cost‑effective treatment option, offering the same clinical efficacy as the original brand while reducing out‑of‑pocket expenses for patients across the UK.

How Cilostazol Works

Cilostazol inhibits the enzyme phosphodiesterase‑3, which normally degrades cyclic adenosine monophosphate (cAMP) within vascular smooth‑muscle cells and platelets. By preventing cAMP breakdown, the drug raises intracellular cAMP concentrations, leading to two principal physiological effects:

1. Vasodilation – Elevated cAMP relaxes smooth‑muscle fibers in peripheral arteries, widening the vessel lumen and increasing blood flow to the lower extremities.
2. Antiplatelet activity – Higher cAMP levels in platelets reduce their activation and aggregation, diminishing the formation of micro‑thrombi that could further impede perfusion.

These actions collectively improve oxygen delivery during exercise, thereby extending the distance a patient can walk before experiencing claudication pain. Cilostazol reaches peak plasma concentrations within 2–4 hours after a single dose, and its elimination half‑life ranges from 11 to 13 hours, supporting a twice‑daily dosing regimen. The drug is primarily metabolised by hepatic CYP3A4 and CYP2C19 isoenzymes and excreted via the urine and feces.

Conditions Treated with Cilostazol

• Intermittent Claudication due to Peripheral Arterial Disease (PAD) – The only indication approved by the European Medicines Agency (EMA) and the MHRA. PAD affects roughly 2–3 % of the UK adult population over 55 years, with higher prevalence in smokers and individuals with diabetes. Cilostazol improves walking distance by 30–50 % in controlled trials, representing a clinically meaningful benefit.

• Secondary Prevention of Atherosclerotic Events (off‑label) – While not formally approved, clinicians sometimes use Cilostazol in patients who cannot tolerate standard antiplatelet agents such as aspirin or clopidogrel, because of its combined vasodilatory and antiplatelet properties.

• Potential Use in Cerebrovascular Disease (investigational) – Small studies have explored Cilostazol’s role in preventing recurrent ischemic stroke, particularly in Asian cohorts. The evidence does not yet support routine use in UK practice, but it illustrates the drug’s broader vascular relevance.

Suitable Candidates for Cilostazol Treatment

Cilostazol is most appropriate for adults who meet the following criteria:

• Diagnosed intermittent claudication confirmed by ankle‑brachial index (ABI) ≤ .90 and consistent symptomatology during exertion.
• Stable cardiovascular status – No recent myocardial infarction, unstable angina, or severe heart failure (NYHA III–IV).
• Absence of contraindications such as active bleeding, severe hepatic impairment, or known hypersensitivity to Cilostazol or any excipients.
• Non‑smokers or patients committed to smoking cessation, as continued tobacco use markedly diminishes therapeutic gains.

Patients who may not be suitable include those with:

• History of intracranial haemorrhage or severe cerebrovascular disease.
• Uncontrolled hypertension (≥ 180/110 mmHg).
• Concomitant use of potent CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) that could raise plasma levels excessively.
• Pregnant or lactating women, because safety data are insufficient.

Clinicians typically consider Cilostazol when supervised exercise programmes have failed to achieve satisfactory functional improvement, or when patients seek an adjunct pharmacological option to augment walking capacity.

Risks, Side Effects, and Interactions

Common

• Headache – Reported in up to 30 % of users, usually mild and transient.
• Dizziness or light‑headedness – Related to vasodilatory effects, particularly when standing quickly.
• Palpitations – May result from increased heart rate secondary to cAMP elevation.
• Diarrhoea or abdominal discomfort – Gastrointestinal upset is frequently mild and resolves with continued therapy.

Rare

• Rash or pruritus – Cutaneous reactions occur in less than 2 % of patients.
• Tinnitus – Occasional auditory disturbance, typically reversible on discontinuation.
• Elevated liver enzymes – Transient increases in ALT/AST may be observed; routine monitoring is advised in patients with pre‑existing liver disease.

Serious

• Severe hypotension – Rare but possible when combined with other vasodilators; may lead to syncope.
• Bleeding complications – Though Cilostazol’s antiplatelet effect is modest, concomitant anticoagulants or antiplatelet drugs can increase the risk of gastrointestinal or intracranial haemorrhage.
• Cardiac arrhythmias – Documented cases of ventricular tachycardia in patients with underlying heart disease; requires immediate medical attention.
• Allergic anaphylaxis – Extremely uncommon; symptoms include swelling of the face, throat, or tongue, and respiratory distress.

Drug–Drug Interactions

• CYP3A4 inhibitors (e.g., itraconazole, ritonavir) – Increase Cilostazol plasma concentrations and may heighten adverse‑event risk.
• CYP2C19 inhibitors (e.g., fluvoxamine) – Similar effect on exposure.
• Anticoagulants (warfarin, direct oral anticoagulants) – Additive bleeding risk; dose adjustments or enhanced monitoring may be required.
• Other antiplatelet agents (aspirin, clopidogrel) – Combined use augments platelet inhibition and should be reserved for specific, high‑risk scenarios.

Patients should disclose all current medications, including over‑the‑counter products and herbal supplements, to their prescriber before initiating Cilostazol.

Practical Use: Dosing, Missed Dose, Overdose

• Standard dosage – The usual adult regimen is 100 mg taken orally twice daily, morning and evening, with or without food. Dosage adjustments are not typically required for age or gender but should be considered in severe hepatic impairment (dose reduction to 50 mg twice daily) or in cases of renal insufficiency (monitor plasma levels closely).
• Missed dose – If a dose is forgotten and the scheduled time for the next dose is less than 4 hours away, skip the missed dose and resume the regular schedule. Do not double‑dose to compensate.
• Overdose – Symptoms may include severe headache, tachycardia, hypotension, and gastrointestinal upset. Immediate medical assessment is advised; supportive care (intravenous fluids, monitoring of vital signs) is the primary treatment. Activated charcoal can be considered if ingestion occurred within one hour and the patient presents early.
• Food and alcohol – Cilostazol can be taken with meals; high‑fat meals modestly increase absorption but do not necessitate dose changes. Alcohol should be limited, as excessive intake may exacerbate dizziness and haemodynamic effects.
• Special populations – Elderly patients (≥ 75 years) may exhibit increased sensitivity to vasodilatory side effects; a cautious titration approach (starting with 50 mg twice daily) may improve tolerability.

Buying Cilostazol from Our Online Pharmacy

Cilostazol can be purchased safely from our online pharmacy in the UK. We specialise in providing verified, high‑quality generic medications at prices close to manufacturer cost, ensuring affordability without compromising safety.

• Affordable pricing – Generic Cilostazol tablets are sourced from MHRA‑approved suppliers, allowing us to offer a cost‑effective alternative to branded Pletal.
• Verified quality – All batches undergo third‑party testing for potency, purity, and compliance with EU‑GMP standards.
• Discreet, reliable delivery – Orders are packaged in plain, unbranded envelopes and dispatched via a tracked service; standard delivery typically arrives within 7 days, with express options available for urgent needs.
• Online‑only accessibility – For patients who encounter limited availability through local pharmacies or wish to avoid long waiting periods, our platform provides a convenient, confidential channel to obtain Cilostazol.

We operate as a pharmacy‑broker service, collaborating with licensed overseas pharmacies that hold the necessary authorisations to ship medication to the UK. This model enables us to maintain a discreet service that respects patient privacy while meeting stringent regulatory requirements.

FAQ

• Is Cilostazol approved for use in patients under 18 years of age?
  No, Cilostazol has not been studied or approved for paediatric use. Clinical trials and safety data are limited to adult populations, and prescribing it to children would be considered off‑label and unsupported by regulatory agencies.

• Can I travel internationally with Cilostazol tablets in my carry‑on luggage?
  Yes, it is permissible to carry your medication in hand luggage, provided you keep it in its original packaging with a clear label. It is advisable to bring a copy of the prescription or a doctor’s note, especially when travelling to countries with strict drug‑import regulations.

• What does the imprint on a Cilostazol tablet look like?
  Generic Cilostazol tablets commonly bear the imprint “100 mg” followed by the manufacturer’s logo (e.g., “CIL 100 MG” or similar). The appearance may vary slightly between suppliers, but the strength and shape are consistent across all authorised products.

• Are there any known food‑drug interactions with Cilostazol?
  Cilostazol does not have major food restrictions. However, grapefruit juice can inhibit CYP3A4 enzymes and modestly increase drug exposure, so regular consumption should be avoided or discussed with a healthcare professional.

• How should Cilostazol be stored in a warm climate?
  The tablets should be kept at a controlled room temperature of 15–30 °C, protected from direct sunlight and humidity. If you live in an environment where indoor temperatures frequently exceed 30 °C, store the medication in a cool, dry cupboard or consider a small insulated container.

• Can Cilostazol affect routine blood tests, such as liver function tests?
  Cilostazol may cause transient elevations in liver enzymes (ALT/AST). Routine monitoring is recommended for patients with pre‑existing liver disease, but occasional mild rises are typically reversible upon discontinuation of the drug.

• Is there a difference between the tablet formulation sold in the EU and that sold in the US?
  The active ingredient, Cilostazol, is identical, but excipients such as fillers or coatings may differ due to regional manufacturing practices. These variations do not alter the therapeutic effect but may influence tolerability for individuals with specific sensitivities.

• Do UK drug‑testing agencies consider Cilostazol a banned substance for athletes?
  Cilostazol is not listed on the World Anti‑Doping Agency (WADA) prohibited list, but athletes should verify with their governing bodies because some sports organisations may have specific regulations concerning vasodilators or antiplatelet agents.

• Can I take Cilostazol if I have a mild allergy to aspirin?
  Cilostazol’s antiplatelet activity is mechanistically distinct from aspirin’s cyclo‑oxygenase inhibition. However, cross‑reactivity is uncommon; patients with an aspirin allergy should still discuss the risk with a clinician before starting Cilostazol.

• What is the shelf‑life of a Cilostazol bottle once opened?
  Unopened packs generally have a shelf‑life of 24 months when stored correctly. Once the bottle is opened, the tablets remain stable for up to 12 months, provided they are kept in a dry environment away from heat and light.

Glossary

Phosphodiesterase‑3 (PDE‑3) Inhibitor

A class of drugs that block the PDE‑3 enzyme, leading to increased intracellular cAMP and resulting in vasodilation and reduced platelet aggregation.

Intermittent Claudication

Cramping pain in the leg muscles that occurs during walking or exercise due to insufficient blood flow, typically relieved by rest.

Ankle‑Brachial Index (ABI)

A non‑invasive test comparing blood pressure in the ankle with that in the arm; values ≤ .90 indicate peripheral arterial disease.

CYP450 Enzymes

A family of liver enzymes (e.g., CYP3A4, CYP2C19) responsible for metabolising many medications; inhibitors of these enzymes can raise drug concentrations.

⚠️ Disclaimer

The information provided about Cilostazol is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Cilostazol for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.