Abstract
Cilostazol is a drug approved for the treatment of patients with peripheral arterial disease in the claudication stage, without resting ischaemic pain and defects. It belongs to the group of substances with antithrombotic action, inhibits activation and aggregation of thrombocytes, and also exhibits vasodilator properties and influences triglyceride and HDL-cholesterol levels.
The combination of the above effects is clinically desirable and is characterised by joint action in one preparation consisting both in therapeutic effects in limb ischaemia and in prevention of its progression. A meta-analysis of controlled clinical studies has shown improved patient performance on walking, with extended claudication-free distance that was approximately double the distance compared to placebo and pentoxifylline.
Cilostazol is contraindicated in advanced renal and liver failure, and should not be administered to patients with the history of tachyarrhythmia, with acute coronary events or after interventions, and is also contraindicated as part of combination of two or more anti-aggregation and anticoagulant preparations. Interactions of cilostazol with other preparations can occur when co-administered with substances that inhibit cytochrome P450 (CYP3A4 or CYP2C19 inhibitors).
Efficacy and appropriateness of continued administration of cilostazol should be assessed 3 months after its initiation. According to current consensus data, cilostazol is included among substances with demonstrated effect on claudication complaints, together with naftidrofuryl.