In January 1999, the U.S. Food and Drug Administration approvedcilostazol(brand name:PLETAL) for the management ofintermittent claudication, a condition in whichpaindevelops in the lower legs duringwalkingand sometimes at rest. It results from narrowing of the arteries that supply the leg muscles with blood and oxygen.
Cilostazol does not cure intermittentclaudicationbut rather reduces thepainso that patients can walk longer before developing pain. In 8 studies, the average improvement in walking distance was 28 to 100% for patients who took cilostazol as compared with -10 to 30% for patients who took a placebo ("sugarpill").
It is not completely known how cilostazol works. Its primary action is to expand the arteries going to the legs, increasing the flow of blood and oxygen to the muscles. It also reduces the ability of blood to clot.
Until now,pentoxifylline(TRENTAL) was the only drug approved for the management of intermittent claudication. TRENTAL improves blood flow by making it easier for red blood cells that carry oxygen to travel through arteries and by decreasing the "stickiness" (viscosity) of blood.
Cilostazol (PLETAL) is a tablet that is taken twice a day. The most common adverse effects areheadache, fast or abnormal heartbeat,abdominal pain,diarrhea,nauseaanddizziness.
Patients withheart failureshould not use cilostazol (PLETAL) because the long-term use ofdrugssimilar to PLETAL among patients withheartfailure has been associated with occasional deaths.
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