How Far Is Too Far? The Ethics of Mini Brain Research
December 11, 2025
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Brand Name :
pletal
Synonyms :
cilostazol
Class :
Antiplatelet agent
Brand Name :
pletal
Synonyms :
cilostazol
Class :
Antiplatelet agent
Dosage Forms & Strengths
Tablet
50mg
100mg
Indicated for Intermittent claudication:
100
mg
Tablet
Orally
twice a day at least 30 minutes before meals or 2 hours after meals
Safety and efficacy not established
Refer adult dosing
may enhance the concentration of serum when combined with cilostazol
may enhance the concentration of serum when combined with cilostazol
may enhance the concentration of serum when combined with cilostazol
may enhance the concentration of serum when combined with cilostazol
may enhance the concentration of serum when combined with cilostazol
cilostazol: they may enhance the serum concentration of CYP3A Inhibitors
cilostazol: they may enhance the serum concentration of CYP3A Inhibitors
cilostazol: they may enhance the serum concentration of CYP3A Inhibitors
cilostazol: they may enhance the serum concentration of CYP3A Inhibitors
cilostazol: they may enhance the serum concentration of CYP3A Inhibitors
cilostazol: they may enhance the serum concentration of CYP2D6 Inhibitors
cilostazol: they may enhance the serum concentration of CYP2D6 Inhibitors
cilostazol: they may enhance the serum concentration of CYP2D6 Inhibitors
cilostazol: they may enhance the serum concentration of CYP2D6 Inhibitors
cilostazol: they may enhance the serum concentration of CYP2D6 Inhibitors
may have an increased anticoagulant effect when combined with heparin
may have an increased anticoagulant effect when combined with heparin
may have an increased anticoagulant effect when combined with heparin
may enhance the serum concentration of CYP3A4 inhibitors
may enhance the serum concentration of CYP3A4 inhibitors
may enhance the serum concentration of CYP3A4 inhibitors
may increase the anticoagulant effect of antiplatelet agents
may increase the serum concnetration when combined
may enhance the serum concentration of CYP3A4 Inhibitors
morphine (Systemic): they may decrease the antiplatelet effect of Antiplatelet Agents (P2Y12 Inhibitors)
omeprazole: they may enhance serum concentrations of cilostazol
may enhance serum concentrations of CYP2C19 Inhibitors
caplacizumab: they may increase the toxic effect of Antiplatelet agents
may have an increased anticoagulant effect when combined with heparin
may have an increased anticoagulant effect when combined with heparin
may have an increased anticoagulant effect when combined with heparin
antiplatelet Properties may enhance the antiplatelet effect of abrocitinib
may enhances the effects of the other by pharmacodynamic synergism
antiplatelet agents increase the antiplatelet effect of abrocitinib
it may enhance the anticoagulant effect of anticoagulants
it may enhance the anticoagulant effect of anticoagulants
it may enhance the anticoagulant effect of anticoagulants
it may enhance the anticoagulant effect of anticoagulants
it may enhance the anticoagulant effect of anticoagulants
it May enhance the antiplatelet effect of Agents with antiplatelet Properties
it May enhance the antiplatelet effect of Agents with antiplatelet Properties
it May enhance the antiplatelet effect of Agents with antiplatelet Properties
it May enhance the antiplatelet effect of Agents with antiplatelet Properties
it May enhance the antiplatelet effect of Agents with antiplatelet Properties
antiplatelet agents may enhance the anticoagulant effect of thrombolytic Agents
choline magnesium trisalicylate
may enhance the adverse/toxic effect of salicylates
choline magnesium trisalicylate
may increase the risk of adverse effect of salicylates
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may enhance the risk of adverse effect of thrombolytic agents
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
choline magnesium trisalicylate
may have an increasingly adverse effect when combined with salicylates
It may enhance the risk of bleeding by affecting coagulation when combined with omega-3 carboxylic acids
It may diminish the effect when combined with griseofulvin by CYP3A4 metabolism
it may diminish the metabolism when combined with azelastine
may have an increased anticoagulant effect when combined with anticoagulants
may have an increased anticoagulant effect when combined with anticoagulants
when bromazepam and cilostazol are used together, there is a potential reduction in the bromazepam's metabolism
tinidazole has the potential to reduce the rate of excretion of cilostazol, potentially leading to an elevation in level of serum
When ponesimod is used together with cilostazol, this leads to enhanced risk or seriousness of bradycardia
When cilostazol is used together with adenosine, this leads to enhanced risk or seriousness of QTc prolongation
When cilostazol is used together with givinostat, this leads to enhanced risk or seriousness of Qtc prolongation
cilostazol leads to a reduction in the rate of excretion of pentaerythritol tetranitrate, which leads to an increased level of serum
When indisulam is used together with cilostazol, this leads to a reduction in cilostazol metabolism
combining piperine with cilostazol may result in a decreased metabolism of cilostazol
cilostazol: it may increase the serum concentration of gestodene
the effect of cilostazol is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
it may increase the antiplatelet effect of properties of antiplatelet drugs
antiplatelet agents may enhance the adverse/toxic effect of ibritumomab tiuxetan
l-methylfolate-pyridoxal 5′-phosphate-methylcobalamine
it may enhance the antiplatelet effect of Agents with antiplatelet Properties
l-methylfolate-pyridoxal 5′-phosphate-methylcobalamine
may increase the antiplatelet effect of agents with antiplatelet properties
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may increase the effect of other agents with antiplatelet drugs
may increase the antiplatelet effect of prostacyclin analogs
may enhance the effect of antiplatelet properties
may increase the anti-coagulant action of anti-coagulants
may increase the antiplatelet effect of antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may have an increasingly adverse effect when combined with Apixaban
may have an increasingly adverse effect when combined with Cephalothin
May have an increased anticoagulant effect when combined with Antiplatelet agents
may have an increasingly adverse effect when combined with Deoxycholic Acid
may have an increasingly adverse effect when combined with Edoxaban
may increase the toxic effect of salicylates
may increase the antiplatelet effect of nonsteroidal anti-inflammatory agents
may have an increased antiplatelet effect when combined with antiplatelet agents
may have an increased antiplatelet effect when combined with antiplatelet agents
may have an increased antiplatelet effect when combined with antiplatelet agents
may have an increased adverse effect when combined with ibritumomab tiuxetan
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
it increases the effect of antiplatelet agents
antiplatelet agents increase the effect of thrombolytic agents
it increases the effect of antiplatelet agents
antiplatelet agents increase the toxicity of obinutuzumab
they increase the efficacy of antiplatelet agents
it increases the efficacy of antiplatelet agents
it increases the efficacy of antiplatelet agents
it increases the toxicity of antiplatelet agents
may increase the adverse effect of pentosan polysulfate sodium
may increase the antiplatelet effect
may enhance the effects by pharmacodynamic synergism when combined with cilostazol
it increases the effect of antiplatelet agents
other antiplatelet agents increase the anticoagulative effect of rivaroxaban
lipid emulsion (plant oil-based)
lipid emulsion: they may increase the toxic effect of antiplatelet agents
pirtobrutinib: they may increase the antiplatelet effect of antiplatelet agents
Vitamin K: they may increase the antiplatelet effect of antiplatelet agents
Vitamin K: they may increase the antiplatelet effect of antiplatelet agents
Vitamin K: they may increase the antiplatelet effect of antiplatelet agents
Vitamin K: they may increase the antiplatelet effect of antiplatelet agents
Vitamin K: they may increase the antiplatelet effect of antiplatelet agents
Vitamin D analogs: they may increase the antiplatelet effect of antiplatelet agents
anagrelide: they may increase the antiplatelet effect of antiplatelet properties
Bile Acid Sequestrants: they may diminish the absorption of Antiplatelet Agent
naftazone : they may increase the antiplatelet effect of antiplatelet agents
porfimer: they may increase the toxic effect of antiplatelet agents
verteporfin: they may increase the antiplatelet effect of Agents with antiplatelet agentss
ramosetron: they may increase the antiplatelet effect of Agents with antiplatelet properties
topiramate: they may increase the antiplatelet effect of Agents with antiplatelet properties
zuclopenthixol: they may increase the antiplatelet effect of Agents with antiplatelet properties
etravirine: they may increase the antiplatelet effect of Agents with antiplatelet agent
alizapride: they may increase the antiplatelet effect of Agents with antiplatelet agent
the rate of metabolism of cilostazol may be reduced
When cilostazol is used together with oliceridine, this leads to reduction in oliceridine’s metabolism
Mechanism of action
It is a phosphodiesterase 3 (PDE3) inhibitor. It increases the levels of cyclic adenosine monophosphate (cAMP) in the body. This leads to the relaxation of the blood vessels and improved blood flow, especially in the legs. It also helps to prevent platelets from sticking together and forming clots.
Cilostazol is indicated for treating symptoms of peripheral arterial disease (PAD) in patients with intermittent claudication, characterized by pain in the legs that occurs with walking and improves with rest. It is also used to prevent recurrent stroke in patients with a high risk of stroke
Frequency defined:
>10%
Diarrhea
Infection
Pharyngitis
Headache
Abnormal stools
rhinitis
1-10%
Palpitations
Back pain
Abdominal pain
Increased cough
Atrial fibrillation
Myocardial infarction
Ecchymosis
Epistaxis
Nausea
Dizziness
Peripheral edema
Dyspepsia
Tachycardia
Myalgia
Congestive heart failure
Hematemesis
Blood in eye
Hemoptysis
Frequency undefined
Agranulocytosis
Leukopenia
Stevens-Johnson syndrome
Decreased platelet aggregation
Aplastic anemia
thrombocytopenia
<1%
Qtc prolongation
Hot flushes
Hyperuricemia
Jaundice
Interstitial pneumonia
Pruritis
Hepatic dysfunction
Pain
Decreased platelet count
Subacute thrombosis
Black box warning
Studies have shown that PDE3 inhibitors, including cilostazol and its metabolites, may harm survival in patients with class III-IV CHF. Therefore, cilostazol is contraindicated in patients with CHF of any severity. It is important to note that CHF is a severe condition, and a specialist should only treat patients with it
Contraindications
Caution
Pregnancy consideration: C
Lactation: Excretion of the drug in human breast milk is unknown
Pregnancy category:
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category.
Pharmacology
It is mainly used to treat symptoms of peripheral arterial disease (PAD) in patients with intermittent claudication and prevent recurrent stroke in patients with a high risk of stroke.
The therapeutic effect of cilostazol in treating intermittent claudication may take 2-12 weeks to occur, and the recommended starting dose is 100 mg twice daily. The dosage can be increased to a maximum of 200 mg twice daily, depending on the response and tolerability of the patient
Pharmacodynamics
It is used to treat the symptoms of intermittent claudication, which is a type of peripheral arterial disease (PAD) characterized by pain, cramping, or tiredness in the legs that occur with walking and improves with rest. This is caused by narrowed or blocked blood vessels in the legs, which leads to reduced blood flow and oxygen supply to the muscles.
It works by inhibiting the enzyme phosphodiesterase 3 (PDE3), which leads to an increase in the levels of a chemical called cyclic adenosine monophosphate (cAMP) in the body. This leads to the relaxation of the blood vessels, which improves blood flow and oxygen supply to the legs. Additionally, cilostazol helps prevent platelets from sticking together and forming clots.
Pharmacokinetics
Absorption
It is rapidly absorbed after oral administration, with peak plasma concentrations occurring within 2-4 hours. However, the onset of its therapeutic effect in treating intermittent claudication may take 2-12 weeks.
Distribution
It is highly protein bound, specifically to albumin, with a 95-98% binding range
Metabolism
It is metabolized mainly by the enzyme CYP3A4 and, to a lesser extent, by CYP2C19. The primary metabolite is 4′-trans-hydroxy-cilostazol, which is pharmacologically active. 3,4-dihydro-cilostazol is another metabolite that is formed
Elimination/Excretion
The elimination half-life of cilostazol is 11-13 hours. It is not dialyzable. cilostazol and its metabolites are excreted mainly in the urine (74%) and, to a lesser extent, in the feces (20%)
Administration
It is administered orally, usually twice a day. The recommended starting dose is 100 mg twice daily, taken at least 30 minutes before breakfast and dinner. The dosage can be increased to a maximum of 200 mg twice daily, depending on the response and tolerability of the patient.
It is essential to take cilostazol precisely as the doctor prescribes and not exceed the recommended dosage. It should be taken at least 30 minutes before breakfast and dinner and with a glass of water. It should be avoided to be taken with other medications that can inhibit platelet aggregation, such as clopidogrel, ticlopidine, or aspirin in high doses
Patient information leaflet
Generic Name: cilostazol
Pronounced: [ sye-LOE-sta-zol ]
Why do we use cilostazol?
An anti-platelet drug and vasodilator called cilostazol is used to treat the symptoms of intermittent claudication
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