Cilostazol is an antiplatelet agent indicated in patients with intermitent claudication to improve maximum and pain-free walking distance and time in peripheral arterial disease.
It has not been shown to be more effective than pentoxifylline in the increment in walking distance without pain.
In trials, the incidence and withdrawal of patients from treatment due to adverse effects was high. The most frequent adverse effects were headache and diarrhoea. In addition, cardiovascular disorders included: vertigo, oedema, palpitations, tachycardia and arrhythmias.
Numerous potentially severe interactions can occur with other drugs: antihypertensives, anticoagulant and antiaggregant agents or proton pump inhibitors.
Conclusion
Cilostazol has not been shown to be more effective than pentoxifylline in the improvement of the maximal and pain free walking distance. The withdrawal of patients from treatment due to adverse effects was high. Cilostazol may considerably increase the risk the patients bear for only a modest benefit which has only been observed for a short-term period.