Cilostazol

Cilostazol is an antiplatelet agent with vasodilating properties that has b een used in the treatment of patients with peripheral ischaemia such as int ermittent claudication. The drug inhibits platelet aggregation induced by ADP, collagen and arachid onic acid. Unlike aspirin (acetylsalicylic acid), cilostazol inhibits both primary and secondary aggregation. It also acts as a Vascular vasodilator by inhibiting calcium-induced contra ctions while having no direct effect on contractile proteins. In double-blind randomised trials, patients with intermittent claudication receiving cilostazol showed significant improvements Versus placebo in term s of time to initial pain and maximal walking or absolute claudication dist ance; these findings were confirmed by cilostazol patients' positive respon ses on subscales measuring physical functioning and quality of life. In a 24-week randomised double-blind trial in patients with intermittent cl audication, cilostazol 100mg twice daily produced significant improvements in pain-free and maximum walking distances, compared with pentoxifylline (o xpentifylline) 400mg 3 times daily and placebo. Cilostazol has been well tolerated, with the most common adverse events bei ng headache, diarrhoea, abnormal stools and dizziness.