Generic Pletal

Introduction

Pletal (generic name cilostazol) is a phosphodiesterase‑3 (PDE‑3) inhibitor used primarily to improve walking distance in adults with intermittent claudication secondary to peripheral arterial disease (PAD). In the United Kingdom the medication is supplied by Bayer and classified under the general‑health group, although its therapeutic focus is vascular. Cilostazol is also investigated for secondary uses such as secondary prevention after ischemic stroke, but its licensed indication in the UK remains intermittent claudication.

What is Pletal?

• Classification: Cilostazol is a selective PDE‑3 inhibitor with antiplatelet and vasodilatory properties.
• Development: The compound was first synthesized in the 199s and received marketing authorisation in several EU member states for the treatment of intermittent claudication.
• Manufacturer: Bayer Ltd produces Pletal under a licence for the European market.

How Pletal Works

Cilostazol inhibits the enzyme phosphodiesterase‑3, leading to increased intracellular cyclic adenosine monophosphate (cAMP) in vascular smooth‑muscle cells and platelets. Elevated cAMP causes:

1. Vasodilation – relaxation of peripheral arteries improves blood flow to the lower limbs.
2. Antiplatelet effect – reduced platelet aggregation lowers the risk of micro‑thrombi that can worsen ischaemia.

The pharmacokinetic profile shows rapid absorption (peak plasma concentrations within 2–4 hours) and a half‑life of approximately 11 hours, allowing twice‑daily dosing. Cilostazol is metabolised principally by cytochrome P450 enzymes CYP 3A4 and CYP 2C19, with renal excretion of metabolites.

Conditions Treated with Pletal

• Intermittent Claudication (Peripheral Arterial Disease) – symptomatic PAD affecting 3–5 % of the UK adult population, most commonly in individuals over 60 years. Cilostazol improves maximal walking distance and pain‑free walking time, as demonstrated in the CLARITY trial (Boden et al., 2003).
• Secondary Prevention after Ischaemic Stroke – while not a licensed indication in the UK, some clinicians use cilostazol off‑label based on Japanese studies showing reduced recurrent stroke risk.

Who is Pletal For?

• Adults with symptomatic intermittent claudication who have a documented ankle‑brachial index ≤ .9 and can tolerate oral therapy.
• Patients who are unsuitable for revascularisation (e.g., due to comorbidities) or who prefer pharmacological management to improve functional capacity.
• Individuals not on concurrent anticoagulants (warfarin, DOACs) because the combined bleeding risk is increased.

Contra‑indications include: active bleeding, recent myocardial infarction, severe heart failure (NYHA III/IV), uncontrolled hypertension, and known hypersensitivity to cilostazol or any excipients.

Risks, Side Effects, and Interactions

Common

• Headache
• Dyspepsia or abdominal discomfort
• Diarrhoea
• Palpitations or tachycardia
• Dizziness

Rare

• Arrhythmias (e.g., atrial fibrillation)
• Myalgia or muscle cramps
• Elevated liver enzymes (ALT, AST)

Serious

• Major bleeding (particularly when combined with anticoagulants or other antiplatelet agents)
• Severe hypotension
• Hepatotoxicity (requiring discontinuation)

Drug–Drug Interactions

• CYP 3A4 / CYP 2C19 inhibitors (e.g., erythromycin, clarithromycin, ketoconazole, fluconazole) increase cilostazol plasma levels → higher risk of side effects.
• Concomitant anticoagulants or dual antiplatelet therapy heighten bleeding risk; co‑administration is generally contraindicated.
• Nicotine (tobacco) may attenuate the vasodilatory effect of cilostazol; smoking cessation is advised.
• Alcohol can exacerbate flushing and headache; moderate consumption is recommended.

Practical Use: Dosing, Missed Dose, Overdose

• Standard dosing: 100 mg taken orally twice daily, preferably with meals to minimise gastrointestinal upset.
• Missed dose: If a dose is forgotten, take it as soon as remembered unless it is within 6 hours of the next scheduled dose; then skip the missed dose and continue the regular schedule. Do not double‑dose.
• Overdose: Symptoms may include severe headache, nausea, vomiting, and rapid heart rate. Seek immediate medical attention; treatment is symptomatic and may involve activated charcoal if presentation is early.

Precautions:

• Assess renal and hepatic function before initiation; dose adjustment is not routinely required but severe impairment warrants discontinuation.
• Avoid use in pregnancy and lactation – insufficient data and potential fetal risk.
• Inform the prescriber of any concurrent medications, especially those listed under interactions.

Buying Pletal from Our Online Pharmacy

Pletal can be purchased from our online pharmacy in the UK with a service model designed for affordability and discretion:

• Cost‑effective pricing – we source the medication close to manufacturer cost, passing savings to the patient.
• Verified quality – all batches are supplied by licensed overseas pharmacies meeting EU‑GMP standards.
• Guaranteed delivery – options include 7‑day express shipping for urgent needs or ~3‑weeks regular airmail for routine orders.
• Discreet service – packages are unmarked and delivered to a secure address of the patient’s choosing, respecting privacy.

Our platform operates as a pharmacy broker service, partnering with accredited international suppliers. This enables patients with limited access to conventional pharmacies or insurance‑based prescribing to obtain clinically appropriate generic cilostazol safely.

FAQ

• Is Pletal available in both brand‑name and generic forms in the UK?
  Yes. The original brand name is Pletal, produced by Bayer, while generic versions contain the same active ingredient, cilostazol, and are typically priced lower.

• What is the recommended storage condition for cilostazol tablets?
  Store at controlled room temperature (15‑30 °C) in a dry place, protected from light and moisture. Do not refrigerate or place the medication in a bathroom cabinet.

• Can I travel internationally with Pletal in my carry‑on luggage?
  Yes, provided the medication is kept in its original packaging with the prescription label (if applicable) and you comply with the destination country’s import rules for personal use.

• Does consuming caffeine affect the efficacy of cilostazol?
  Caffeine is a mild CYP 1A2 inducer and does not significantly interact with cilostazol metabolism; moderate coffee intake is generally safe.

• Are there formulation differences between the EU and Asian markets?
  The active ingredient remains identical, but excipients such as lactose or magnesium stearate may vary. Patients with specific allergies should review the full ingredient list provided by the supplier.

• Will Pletal show up on a standard drug test?
  Cilostazol is not typically screened for in routine workplace drug testing panels because it is not a controlled substance.

• Is there a risk of false‑positive results in laboratory tests while on cilostazol?
  Rarely, cilostazol can interfere with certain clotting assays, leading to slightly prolonged prothrombin time. Clinicians should be informed if the patient is undergoing coagulation testing.

• Can I import Pletal for personal use without a prescription in the UK?
  Personal importation of a single‑course supply is permitted under UK law if the medication is for a personal medical need, the patient has a valid prescription from a UK‑registered prescriber, and the product complies with the MHRA’s import guidelines.

• What are the differences between immediate‑release and extended‑release cilostazol formulations?
  Currently, only immediate‑release tablets are marketed in the EU; extended‑release versions are under investigation and not yet available.

• How does smoking influence the therapeutic effect of Pletal?
  Nicotine induces vasoconstriction, counteracting the vasodilatory action of cilostazol. Smoking cessation enhances clinical outcomes and is strongly recommended.

Glossary

Peripheral Arterial Disease (PAD)

A chronic atherosclerotic condition characterised by narrowing of arterial vessels in the limbs, leading to reduced blood flow and symptoms such as intermittent claudication.

Phosphodiesterase‑3 (PDE‑3) Inhibitor

A drug class that blocks the PDE‑3 enzyme, resulting in increased intracellular cAMP, which promotes vasodilation and inhibits platelet aggregation.

Cytochrome P450 (CYP) Enzymes

A family of liver enzymes (e.g., CYP 3A4, CYP 2C19) responsible for the metabolism of many medicines; inhibitors or inducers of these enzymes can alter drug concentrations.

Antiplatelet

Refers to agents that reduce platelet aggregation, thereby decreasing the formation of clots in the blood vessels.

⚠️ Disclaimer

The information provided about Pletal 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 Pletal 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.