Cilostazol

Medications similar to cilostazol caused an increased risk of death in patients with congestive heart failure (condition in which the heart is unable to pump enough blood to the other parts of the body). Tell your doctor if you have or have ever had congestive heart failure. Your doctor will probably tell you not to take cilostazol.

Talk to your doctor about the risks of taking cilostazol.

Cilostazol is used to reduce the symptoms of intermittent claudication (pain in the legs that worsens when walking and improves when resting that is caused by narrowing of the blood vessels that supply blood to the legs). Cilostazol is in a class of medications called platelet-aggregation inhibitors (antiplatelet medications). It works by improving blood flow to the legs.

Cilostazol comes as a tablet to take by mouth. It is usually taken twice a day, at least 30 minutes before or 2 hours after breakfast and dinner. Take cilostazol at around the same times every day. Follow the directions on the prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take cilostazol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Cilostazol controls the symptoms of intermittent claudication but does not cure it. Although you may notice improvements in 2 to 4 weeks, it may take up to 12 weeks before you notice the full benefit (increased walking distance) of cilostazol. Continue taking cilostazol even if you feel well. Do not stop taking cilostazol without talking to your doctor.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking cilostazol,

• tell your doctor and pharmacist if you are allergic to cilostazol, any other medications, or any of the ingredients in cilostazol. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (''blood thinners'') such as warfarin (Coumadin); aspirin; antifungal medications such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); antiplatelet medications such as clopidogrel (Plavix), prasugrel (Effient), and ticlopidine (Ticlid); clarithromycin (Biaxin); diltiazem (Cardizem, Dilacor, Tiazac, others); erythromycin (E-mycin, Ery-Tab, others); fluoxetine (Prozac); fluvoxamine (Luvox); nefazadone; omeprazole (Prilosec); and sertraline (Zoloft). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have bleeding ulcers (sores in the lining of the stomach or small intestine that are bleeding), bleeding in the brain, bleeding from any other part of your body, a low number of platelets in your blood, or any other condition that causes severe bleeding. Your doctor will probably tell you not to take cilostazol.
• tell your doctor if you have or have ever had heart, kidney, or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking cilostazol, call your doctor.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Cilostazol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• diarrhea
• dizziness
• heartburn
• nausea
• stomach pain
• muscle pain

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• fast or irregular heartbeat
• unusual bleeding or bruising
• swelling of the arms, hands, feet, ankles, or lower legs

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include the following:

• severe headache
• dizziness
• fainting
• diarrhea
• fast or irregular heartbeat

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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