Cilostazol: what it does and who it's for

Cilostazol (brand name Pletal) is a prescription drug used to ease leg pain from poor blood flow — called intermittent claudication. If your legs cramp or get tired after walking a short distance, cilostazol can help you walk farther and feel less discomfort. It’s not a cure, but it can improve daily life for many people with peripheral artery disease (PAD).

How cilostazol works and how to take it

Cilostazol blocks an enzyme (phosphodiesterase III) which relaxes blood vessels and reduces platelet clumping. That increases blood flow to the legs. The usual dose is 100 mg twice daily, taken about 30 minutes before a meal or two hours after eating. Consistency matters — take it at the same times each day.

Expect gradual improvement. Some people notice benefits in a few weeks, but full effect can take 12 weeks. This drug treats symptoms of claudication; it does not open blocked arteries like surgery or stents might.

Side effects, warnings, and interactions

Common side effects include headache, diarrhea, dizziness, and palpitations. Serious risks are rare but include bleeding, irregular heartbeat, and worsening heart failure. Don’t use cilostazol if you have heart failure — it can make it worse.

Cilostazol is broken down by liver enzymes (CYP3A4 and CYP2C19). Strong CYP3A4 inhibitors — like ketoconazole, clarithromycin, or certain HIV drugs — raise cilostazol levels and increase side effects. Grapefruit can do the same. It can also increase bleeding risk if used with anticoagulants or strong antiplatelet drugs; your doctor will weigh benefits versus risks.

Pregnancy and breastfeeding: there’s limited data, so doctors usually avoid it. If you’re pregnant, planning pregnancy, or breastfeeding, discuss safer options with your provider.

Stop and seek help if you get chest pain, sudden breathlessness, severe swelling, signs of major bleeding, or very fast/irregular heartbeat.

Buying and storing: cilostazol requires a valid prescription. Beware of online pharmacies that don’t verify prescriptions or lack clear licensing. Look for a physical address, verified reviews, and secure payment. Store tablets at room temperature away from moisture and light.

When to call your doctor: if your walking distance hasn’t improved after about 12 weeks, if side effects bother you, or if you start new medications (including supplements) that might interact. Tell your doctor about all drugs you take, especially blood thinners and strong antibiotics.

Quick practical tips: always follow the 100 mg twice-daily schedule unless your doctor changes it; take doses on an empty stomach for best absorption; keep a list of medications handy; never mix cilostazol with untreated heart failure. With careful use and medical follow-up, cilostazol can be a useful tool to reduce walking pain and get you moving again.