Side Effects of cilostazol: A Synthesis of Findings from 29 Studies

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Original Abstract of the Article

Main Research Findings

Cilostazol is a drug commonly used to treat peripheral artery disease, particularly intermittent claudication. Its effectiveness and safety have been extensively studied. For example, 19 found that cilostazol significantly increased walking distance in patients with intermittent claudication without significant safety concerns. Furthermore, 5 demonstrated that cilostazol prevented age-related decline in hippocampus-dependent memory in mice, suggesting its potential benefit for cognitive function. These findings highlight cilostazol's potential for treating not only intermittent claudication but also cognitive decline.

Reasons for Side Effects

Cilostazol's side effects stem from its mechanism of action. It works by inhibiting platelet aggregation and dilating blood vessels, which can lead to side effects such as headache, diarrhea, tachycardia, and dizziness. Additionally, cilostazol is metabolized by the liver and excreted by the kidneys, so impaired liver or kidney function can increase the risk of side effects.

Common Side Effects

Headache

Headache is a common side effect of cilostazol. 19 found headache to be the most frequent side effect reported. These headaches are usually mild and disappear upon discontinuation of the medication.

Diarrhea

Diarrhea is another commonly reported side effect of cilostazol. 19 also noted diarrhea among the reported side effects. Similar to headache, diarrhea is typically mild and resolves after stopping the medication. However, it's crucial to consult your doctor if you experience severe diarrhea.

Tachycardia

Cilostazol can increase heart rate, a side effect often observed due to its blood vessel dilation and improved blood flow. This tachycardia is generally mild and resolves upon discontinuation of the medication. However, if you experience severe tachycardia, it's essential to seek medical advice.

Dizziness

Dizziness is another potential side effect of cilostazol, often attributed to its ability to lower blood pressure. Similar to other side effects, dizziness is typically mild and resolves upon discontinuation of the medication. However, if you experience severe dizziness, it's vital to consult your doctor.

Gastrointestinal Symptoms

Cilostazol can also cause gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and loss of appetite. These symptoms are generally mild and resolve upon discontinuation of the medication. However, if you experience severe gastrointestinal symptoms, it's important to seek medical advice.

Other

Cilostazol may cause other side effects, including rash, itching, and swelling. These symptoms are generally mild and resolve upon discontinuation of the medication. However, it's essential to consult your doctor if you experience severe or persistent symptoms.

Measures for Side Effects

Measures for Headache

If you experience a headache, consult your doctor. They may prescribe headache medication. Getting adequate rest is also important.

Measures for Diarrhea

Consult your doctor if you have diarrhea. They may prescribe anti-diarrheal medication. Drinking plenty of fluids is also important to prevent dehydration. Consider drinking sports drinks for extra electrolytes.

Measures for Tachycardia

Consult your doctor if you experience tachycardia. They may prescribe medication to lower your heart rate. Rest and avoid excessive exercise during this time.

Measures for Dizziness

Consult your doctor if you experience dizziness. They may prescribe dizziness medication. Stand up slowly to avoid falls. Also, make sure to drink plenty of fluids.

Measures for Gastrointestinal Symptoms

Consult your doctor if you experience gastrointestinal symptoms. They may prescribe medication for gastrointestinal issues. Be mindful of your diet, avoiding fatty foods and stimulants.

Other

If you experience any other side effects, consult your doctor. They may prescribe medication for the specific side effect or advise stopping the drug.

Comparison Between Studies

Common Points in Studies

Numerous studies have consistently found that cilostazol is effective for treating intermittent claudication and is generally safe. However, side effects have been observed in some patients.

Differences in Studies

The specific side effects of cilostazol may vary across different studies. This variation can be attributed to factors such as patient age, sex, health status, dosage, and duration of medication use. Research methodologies can also influence the results obtained.

Points to Note When Applying to Real Life

Take cilostazol as prescribed by your doctor. Do not stop taking it or change the dosage without consulting them. If you have concerns about side effects, discuss them with your doctor. Cilostazol should not be taken by pregnant or breastfeeding women. If you have impaired liver or kidney function, a history of heart disease, or high blood pressure, talk to your doctor before starting cilostazol.

Current Limitations of Research

Research on the side effects of cilostazol is still ongoing, and there is a lack of comprehensive data. Long-term side effects are not yet fully understood. Furthermore, individual responses to cilostazol can vary, making it challenging to predict potential side effects with certainty.

Future Directions for Research

More research is needed to investigate the long-term side effects of cilostazol and the individual variability in responses. Studies focusing on methods for mitigating cilostazol's side effects are also crucial. These research efforts are essential to gain a more comprehensive understanding of the safety and effectiveness of cilostazol.

Conclusion

Cilostazol is an effective medication for treating intermittent claudication. However, be aware of potential side effects, including headache, diarrhea, tachycardia, and dizziness. If you experience any of these side effects, consult your doctor. Take cilostazol as prescribed and avoid stopping or altering the dosage without consulting your doctor.

Keywords
Benefit Keywords
STEMI treatment
1
IS prevention
2
Decreased amputation rates
IC treatment
Improved quality of life
Increased walking capacity
4
Prevent cognitive decline
5
cilostazol treatment
6
Controlled release
Improved treatment efficiency
7
Bradycardia
8
Ischemic event prevention
Thrombotic disease treatment
9
Improved TcpO2
Reduced ischemic symptoms
10
Antiplatelet therapy
11
Prevent stent thrombosis
Reduce thrombotic complications
12
Hearing protection
Vestibular protection
13
Anti-thrombotic
14
Comparable antithrombotic
Lower revascularization
Reduced restenosis
15
Stent thrombosis prevention
17
Reduced cardiovascular events
18
Improved quality of life
Increased walking distance
19
Pharmacological treatment
20
Anti-inflammatory activity
CLZ nanoencapsulation
21
Improved drug solubility
Sustained blood concentration
22
TAPT decreases TLR
TAPT decreases TVR
TAPT improves angiographic outcomes
23
Quality of life
Walking capacity
24
claudication symptom relief
25
Cognitive function improvement
26
ischemic stroke treatment
27
Cardiac event reduction
28
Restenosis prevention
29
Risk Keywords
platelet function
2
Nephrotoxicity
3
Diarrhoea
Flatulence
Headache
Loose stools
4
cardiovascular side effects
6
Sick sinus syndrome
8
Bleeding risk
9
Headache
Palpitations
10
Hepatic dysfunction
11
Major bleeding
Neutropenia
Thrombocytopenia
12
Bleeding
14
Side effects
15
Increased side effects
18
Diarrhea
Dizziness
Headache
Palpitation
Tachycardia
19
Hereditary susceptibility
20
TAPT increases gastrointestinal side effects
TAPT increases headache
TAPT increases palpitations
TAPT increases rash
23
Adverse events
24
hemorrhagic transformation
27
Drug discontinuation
Gastrointestinal side effects
Headache
Rash
28
Adverse drug reactions
29
Literature analysis of 29 papers
Positive Content
27
Neutral Content
1
Negative Content
1
Article Type
4
4
1
7
29
1.

Efficacy and safety of cilostazol-based triple antiplatelet therapy compared with clopidogrel-based dual antiplatelet therapy in patients with acute ST-elevation myocardial infarction undergoing percutaneous coronary intervention: A multicenter, randomized, open-label, phase 4 trial.

Author: ParkSoohyung, RhaSeung-Woon, ChoiByoung Geol, KimWoohyeun, ChoiWoong Gil, LeeSeung Jin, LeeJae Beom, ParkJi Young, ParkSang Min, JeongMyung Ho, KimYong Hoon, HerAe-Young, KimMin Woong, ChenKang-Yin, KimBae Keun, ShinEun-Seok, SeoJae-Bin, AhnJihun, ChoiSe Yeon, ByunJae Kyeong, ChaJin Ah, HyunSu Jin, ChoiCheol Ung, ParkChang Gyu

STEMI treatment

This review explores the optimal duration of triple antiplatelet therapy (TAT) in patients with ST-elevation myocardial infarction (STEMI) as prior studies have shown that TAT, involving the addition of cilostazol to dual antiplatelet therapy (DAT; aspirin + clopidogrel), had better clinical outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Description of a Novel Phosphodiesterase (PDE)-3 Inhibitor Protecting Mice From Ischemic Stroke Independent From Platelet Function.

Author: BieberMichael, SchuhmannMichael K, VolzJulia, KumarGangasani Jagadeesh, VaidyaJayathirtha Rao, NieswandtBernhard, PhamMirko, StollGuido, KleinschnitzChristoph, KraftPeter

IS prevention
platelet function

This study analyzed the efficacy and mechanisms of a novel PDE-3 inhibitor (substance V) in a mouse model of focal cerebral ischemia. Substance V significantly reduced infarct volumes and improved neurological outcomes by reducing blood-brain barrier damage, attenuating brain tissue inflammation, and decreasing local cell death.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Cilostazol-induced Acute Kidney Injury in A Patient With Diabetic Foot Ulcer: A Case Report and Review of Literature.

Author: ShahidiShahrzad, Kabiri NaeiniElham, Mazaheri-TehraniSadegh

Nephrotoxicity

This case report describes a 53-year-old woman who developed acute kidney injury, probably drug-induced acute interstitial nephritis, due to Cilostazol use.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Pharmacotherapy of intermittent claudication.

Author: DoggrellS A

Decreased amputation rates
IC treatment
Improved quality of life
Increased walking capacity
Diarrhoea
Flatulence
Headache
Loose stools

Cilostazol, a specific inhibitor of phosphodiesterase 3 and activator of lipoprotein lipase, clearly increases pain-free and absolute walking distances in claudicants. However, cilostazol does cause minor side effects including headache, diarrhoea, loose stools and flatulence.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Impact of Cilostazol Pharmacokinetics on the Development of Cardiovascular Side Effects in Patients with Cerebral Infarction.

Author: YokoyamaTasuku, YamauchiShigeru, YamagataKeishi, KaneshiroYuta, UranoYumiko, MurataKeiji, MaedaToshio, AsaharaYoshinori, KagawaYoshiyuki

cilostazol treatment
cardiovascular side effects

This study investigated the impact of polymorphisms of metabolic enzymes on plasma concentrations of cilostazol and its metabolites, and the influence of the plasma concentrations and polymorphisms on the cardiovascular side effects in patients with cerebral infarction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

8.

Efficacy of cilostazol for sick sinus syndrome to avoid permanent pacemaker implantation: A retrospective case-control study.

Author: SonouraTakuryu, KoderaSatoshi, ShakyaSandeep, KandaJunji

Bradycardia
Sick sinus syndrome

This study investigated the efficacy of cilostazol, a phosphodiesterase inhibitor, for treating sick sinus syndrome (SSS) to avoid permanent pacemaker (PM) implantation. The study aimed to explore alternative treatments for bradycardia, given the limitations of PM implantation and the lack of consensus on optimal medication regimens.

Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Novel agents for anti-platelet therapy.

Author: JiXuebin, HouMing

Ischemic event prevention
Thrombotic disease treatment
Bleeding risk

New anti-platelet drugs with improved efficacy and reduced hemorrhagic risks are needed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Cilostazol Can Increase Skin Oxygen Supply Assessed by Transcutaneous Oxygen Pressure Measurement in Type 2 Diabetes With Lower Limb Ischemic Disease: A Randomized Trial.

Author: ZhangJinglu, XiaoZidong, ChenLihong, LiLi, YangHaiyun, LuoBaoming, MaiLifang, YanLi, YangChuan

Improved TcpO2
Reduced ischemic symptoms
Headache
Palpitations

Cilostazol 100 mg twice daily for 8 weeks was safe and well tolerated for the treatment of type 2 diabetes with lower limb ischemic disease. Cilostazol significantly improved transcutaneous oxygen pressure and ischemic symptoms compared to acetylsalicylic acid.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Antiplatelet therapy after coronary intervention in Asia and Japan: the Asian perspective of antiplatelet intervention.

Author: GotoS, TodaE

Antiplatelet therapy
Hepatic dysfunction

Clinical databases for Asian patients are not large enough to develop region-specific clinical guidelines.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Triple versus dual antiplatelet therapy after coronary stenting: impact on stent thrombosis.

Author: LeeSeung-Whan, ParkSeong-Wook, HongMyeong-Ki, KimYoung-Hak, LeeBong-Ki, SongJong-Min, HanKi Hoon, LeeCheol Whan, KangDuk-Hyun, SongJae-Kwan, KimJae-Joong, ParkSeung-Jung

Prevent stent thrombosis
Reduce thrombotic complications
Major bleeding
Neutropenia
Thrombocytopenia

A study compared the efficacy and safety of dual and triple antiplatelet therapy after coronary stenting. Triple therapy with aspirin, clopidogrel or ticlopidine, and cilostazol was more effective in preventing thrombotic complications without increasing the risk of side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

RACTS: a prospective randomized antiplatelet trial of cilostazol versus ticlopidine in patients undergoing coronary stenting: long-term clinical and angiographic outcome.

Author: GeJunbo, HanYaling, JiangHong, SunBaogui, ChenJiyan, ZhangShuyang, DuZhimin,

Comparable antithrombotic
Lower revascularization
Reduced restenosis
Side effects

This study compared the efficacy of cilostazol and ticlopidine for the prevention of late restenosis and stent thrombosis after coronary stent implantation. Cilostazol was found to be comparable to ticlopidine in terms of antithrombotic effects, but it resulted in a significantly lower rate of target lesion revascularization.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

16.

Efficacy and safety of triple-antiplatelet therapy after percutaneous coronary intervention: a meta-analysis.

Author: ZhangYong, TangHai-qin, LiJin, FuZhao-xin

This meta-analysis evaluates the efficacy and safety of triple antiplatelet therapy (TAT) with cilostazol, aspirin, and clopidogrel in patients after percutaneous coronary intervention (PCI).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Comparison of cilostazol and clopidogrel after successful coronary stenting.

Author: LeeSeung-Whan, ParkSeong-Wook, HongMyeong-Ki, LeeCheol Whan, KimYoung-Hak, ParkJae-Hyeong, KangSu-Jin, HanKi-Hoon, KimJae-Joong, ParkSeung-Jung

Stent thrombosis prevention

Cilostazol and clopidogrel have comparable safety and efficacy in preventing thrombotic complications following coronary stenting.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Triple versus dual antiplatelet therapy in acute coronary syndromes: adding cilostazol to aspirin and clopidogrel?

Author: NiaziAsfandyar K, DinicolantonioJames J, LavieCarl J, O'KeefeJames H, MeierPascal, BangaloreSripal

Reduced cardiovascular events
Increased side effects

Cilostazol, a phosphodiesterase III inhibitor, has shown promise as an alternative or supplementary antiplatelet therapy in patients receiving aspirin and clopidogrel. Cilostazol significantly improves high on-treatment platelet reactivity and has antiproliferative effects, reducing the risk of restenosis after coronary stent implantation. Triple antiplatelet therapy (TAPT) with cilostazol, aspirin, and clopidogrel has been associated with greater platelet inhibition and reduced major adverse cardiovascular events, with no increased risk of hemorrhagic events. However, larger randomized controlled trials are needed to compare TAPT versus DAPT.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Pharmacological treatment for Buerger's disease.

Author: CacioneDaniel G, MacedoCristiane R, Baptista-SilvaJose C C

Pharmacological treatment
Hereditary susceptibility

Buerger's disease, a non-atherosclerotic inflammatory condition affecting small and medium-sized blood vessels, often has no revascularization options. This review discusses the pharmacological treatment options for patients with severe complications, such as ischemic ulcers or rest pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Carbohydrate-Derived Polytriazole Nanoparticles Enhance the Anti-Inflammatory Activity of Cilostazol.

Author: RivasM Verónica, MusikantDaniel, Díaz PeñaRocío, ÁlvarezDaniela, PelazzoLuciana, RossiEzequiel, MartínezKarina D, ErreaMaría I, PérezOscar E, VarelaOscar, KolenderAdriana A

Anti-inflammatory activity
CLZ nanoencapsulation

This study developed new nanoparticles (NPs) from d-galactose for the efficient encapsulation of cilostazol (CLZ). This method resulted in stable, non-toxic NPs that enhanced the anti-inflammatory activity of CLZ, potentially offering improved treatment for intermittent claudication.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Efficacy and safety of cilostazol based triple antiplatelet treatment versus dual antiplatelet treatment in patients undergoing coronary stent implantation: an updated meta-analysis of the randomized controlled trials.

Author: ChenJun, MengHaoyu, XuLei, LiuJie, KongDeyu, ChenPengsheng, GongXiaoxuan, BaiJianling, ZouFengwei, YangZhijian, LiChunjian, EikelboomJohn W

TAPT decreases TLR
TAPT decreases TVR
TAPT improves angiographic outcomes
TAPT increases gastrointestinal side effects
TAPT increases headache
TAPT increases palpitations
TAPT increases rash

This meta-analysis of 19 trials involving 7,464 patients compared cilostazol-based triple antiplatelet therapy (TAPT) with dual antiplatelet therapy (DAPT) in patients undergoing coronary stent implantation. TAPT improved angiographic outcomes and reduced the risk of target lesion revascularization (TLR) and target vessel revascularization (TVR), but did not reduce major cardiovascular events and was associated with an increase in minor adverse events.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

26.

Cilostazol may improve cognition better than clopidogrel in non-surgical adult patients with ischemic moyamoya disease: subanalysis of a prospective cohort.

Author: AndoSatoshi, TsutsuiShouta, MiyoshiKenya, SatoShinpei, YanagiharaWataru, SettaKengo, ChibaTakayuki, FujiwaraShunrou, KobayashiMasakazu, YoshidaKenji, KuboYoshitaka, OgasawaraKuniaki

Cognitive function improvement

This study investigates the effects of clopidogrel and cilostazol, two antiplatelet drugs, on cognitive function in adult patients with ischemic moyamoya disease (MMD). While both drugs reportedly improve cognitive function over time, the study aims to determine which drug is more effective in non-surgical patients without severe hemodynamic compromise.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

29.

Comparison of ticlopidine and cilostazol for the prevention of restenosis after percutaneous transluminal coronary angioplasty.

Author: NagaokaN, MatsubaraT, OkazakiK, MasudaN, ShikauraK, HottaA

Restenosis prevention
Adverse drug reactions

This study compared the effects of ticlopidine and cilostazol, both antiplatelet agents, on the prevention of restenosis after percutaneous transluminal coronary angioplasty (PTCA). Both drugs demonstrated effectiveness in preventing restenosis, with ticlopidine potentially associated with slight side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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