Cilostazol

• 6 - [ 4 - (1 -cyclohexyl- 1H-tetrazol- 5-yl) butoxy ] -3,4- dihydroquinoline -2-one (IUPAC)

B01AC

Phosphodiesterase inhibitors

> 5000 mg · kg -1 ( LD50, rat, oral)

Template: Infobox chemical / molecular formula search available

Cilostazol ( Pletal ® trade name, manufacturer Otsuka ) is a drug from the group of selective phosphodiesterase 3 inhibitor. It is used for the symptomatic treatment of arterial disease (PAD ).

Commercial forms

Cilostazol tablets there under the name Pletal ( pharmaceutical entrepreneur: Otsuka Pharmaceutical Europe ) in the doses 50 mg and 100 mg. Pletal is distributed in Germany by UCB Pharma and its subsidiary Sanol.

Mechanism of Action

Cilostazol is an inhibitor of phosphodiesterase type III. The inhibition of phosphodiesterase increased the concentration of cyclic adenosine monophosphate (cAMP ). Thus, the endothelial function and the aggregation of platelets ( platelet aggregation) improved is inhibited. Due to the growth inhibition of vascular smooth muscle cells, it also comes at a vasodilator effect.

Areas of application

Cilostazol is used to prolong the pain- free walking distance in peripheral arterial disease (PAD ) in stage 2 ( intermittent claudication ). The recommended dosage of cilostazol is 100 mg 2 times a day.

Because of reports of cardiovascular and hemorrhagic reactions and interactions, the European Medicines Agency benefits and risks of cilostazol has reviewed. The indication was restricted and then changed the recommendations regarding dosage, contraindications and special warnings:

Cilostazol should be prescribed only for patients for whom lifestyle changes have (for example, smoking cessation, exercise, diet), the symptoms of claudication improved intermittens not sufficient ( "second line use" ). It should not be administered to patients taking two or more antiplatelet agents or anticoagulants and in patients with unstable angina or myocardial infarction or coronary intervention in the last six months or with a severe tachyarrhythmia in prehistory.

In patients treated with cilostazol patients should be routinely checked whether the treatment is still appropriate and consistent with the revised contraindications, special warnings and precautions.

Side effects

The most common side effects are headache described and diarrhea. It further major adverse cardiovascular and hemorrhagic events have been reported, which is why the European Medicines Agency has launched a risk assessment process in May 2011.

When neuraxial anesthesia procedures ( spinal or epidural ) Cilostazol should be discontinued 42 hours before and at the earliest given five hours after the procedure.