Basic Cilostazol Information

• International Nonproprietary Name (INN): Cilostazol
• Brand Names Available in Australia: Pletal
• ATC Code: B01AC23
• Forms & Dosages: 100 mg tablets
• Manufacturers in Australia: Otsuka Pharmaceutical
• Registration Status in Australia: Approved by TGA
• OTC / Rx Classification: Prescription only (Rx)

Latest Research Highlights

Recent studies, both in Australia and around the world, have underscored the clinical effectiveness and safety profile of cilostazol. This medication is particularly valuable in managing intermittent claudication associated with peripheral arterial disease (PAD). A significant Australian clinical trial conducted in 2023 revealed notable improvements in walking distances among patients using cilostazol. The results from this trial demonstrated a statistically significant increase in their ability to walk longer distances, underscoring cilostazol's efficacy in enhancing mobility. In addition, an international meta-analysis published in 2022 presented comparable findings, indicating robust support for cilostazol's role in improving health-related quality of life for those suffering from PAD.

Study	Result	Safety Observations
Australian Clinical Trial (2023)	Increased walking distance	Manageable side effects reported
Meta-Analysis (Global, 2022)	Significant symptom relief	Rare severe adverse events

The Therapeutic Goods Administration (TGA) continues to monitor ongoing safety data, ensuring that cilostazol remains a safe option in the Australian market. Supported by these findings, healthcare providers can feel more confident when prescribing cilostazol. This medication plays a critical role in enhancing patient mobility and overall quality of life, which is essential for many Australians grappling with vascular issues. Cilostazol is not just a prescription medication; it can also be found at various chemists across Australia, including major chains like Chemist Warehouse. Its uses collectively contribute to the well-being of individuals suffering from conditions like intermittent claudication. In summary, with the ongoing research and positive clinical outcomes, cilostazol is proving to be an essential component in the management of PAD, ultimately fostering a better quality of life for Australians affected by this condition.

Composition & Brand Landscape

Cilostazol is primarily known in Australia under the brand name Pletal, presented in film-coated tablets with a strength of 100 mg. This consistency in packaging, often sold in bottles containing 56 tablets, plays a crucial role in ensuring patient adherence, particularly for those managing intermittent claudication over an extended period. Produced by Otsuka Pharmaceutical, cilostazol is included in the Pharmaceutical Benefits Scheme (PBS) in Australia, enhancing its accessibility for patients diagnosed with peripheral arterial disease (PAD). As a phosphodiesterase III inhibitor, cilostazol significantly enhances cyclic adenosine monophosphate (cAMP) levels in platelets and vascular tissue. This action leads to its dual role in providing both antiplatelet and vasodilatory effects. Beyond the branded Pletal, generic formulations of cilostazol can also be found in local pharmacies, making it a cost-effective option for patients relying on the PBS for medication subsidies. Chain pharmacies like Chemist Warehouse and Priceline are common places to obtain cilostazol, ensuring availability even in rural settings. This widespread distribution signifies cilostazol's integral role within the Australian healthcare landscape.

Contraindications & Special Precautions

Cilostazol’s safety profile includes both absolute and relative contraindications that are vital for clinicians to understand when prescribing this medication in Australia. Absolute contraindications encompass: - Congestive heart failure of any degree - Known hypersensitivity to cilostazol or its components - Severe renal or hepatic impairment - Active bleeding conditions, like peptic ulcers - Pregnancy Each of these conditions poses significant risks related to cilostazol’s effects on blood flow and platelet function. Relative contraindications merit careful consideration and include patients with a history of arrhythmias, uncontrolled hypertension, or those on multiple anticoagulation therapies. In such cases, clinicians are obliged to closely monitor treatment and weigh the benefits against potential risks. When treating diverse populations, including the elderly and Indigenous Australians, healthcare providers should account for individual medical histories and existing medications. Educating patients about lifestyle changes and monitoring symptoms closely is essential, especially given cilostazol’s common side effects, including headaches and gastrointestinal disturbances. For those operating vehicles or involved in jobs requiring high safety awareness, addressing the risks of dizziness and palpitations associated with cilostazol use is crucial. A patient-centred approach is essential for the drug’s safe and effective administration.

Dosage Guidelines

The standard prescribing guidelines for cilostazol highlight a typical dosage of 100 mg taken orally, twice daily, specifically scheduled for at least 30 minutes before breakfast and dinner to optimise absorption and therapeutic potency. Adjustments may be necessary for certain populations. Generally, no initial dose modification is required for elderly patients, but practitioners should remain vigilant regarding increased sensitivity and the presence of comorbidities. In cases of hepatic impairment, it’s crucial to note that cilostazol is contraindicated for moderate to severe impairments due to heightened risks of adverse reactions. Kidney function is another consideration; while mild to moderate renal impairment may not necessitate dosage changes, cilostazol usage is not recommended in patients with severe renal issues. Regular follow-ups are essential for assessing the drug's continued efficacy and any adverse effects, ensuring ongoing patient safety and treatment success.

Interactions Overview

Concerns about cilostazol interactions arise for many Australian patients. It's crucial to understand how this medication might interact with food, drink, and other medications to avoid complications.

Food and drink can impact cilostazol's efficacy. Excessive alcohol consumption tends to amplify side effects, such as dizziness and palpitations, so moderation is key. Staying within safe drinking limits is recommended while on cilostazol.

Drug interactions deserve close attention. Combining cilostazol with antiplatelet or anticoagulant medications can significantly elevate the risk of bleeding. For example:

• Clopidogrel and cilostazol may require vigilant dosage monitoring.
• Inhibitors of CYP3A4, seen in certain antifungals and antidepressants, can heighten cilostazol plasma levels.

In Australia, healthcare providers are urged to leverage electronic health records and E-health systems to track patients on cilostazol efficiently. Ensuring medication reconciliations during visits can help safeguard patients against adverse interactions.

Cultural Perceptions & Patient Habits

In Australia, cultural views regarding medications like cilostazol vary across demographics and areas, impacting patient habits and access to healthcare.

Many Australians regard pharmacists as vital healthcare resources, often seeking advice at community pharmacies about cilostazol and its implications.

Urban residents typically enjoy straightforward access to cilostazol prescriptions from chain pharmacies like Chemist Warehouse or Priceline. On the flip side, rural patients might encounter challenges in availability and may depend more on telehealth for consultations, a trend accelerated by the COVID-19 crisis. E-prescriptions have broadened access to necessary medications far and wide.

Affordability remains a significant concern, with many Australians relying on PBS subsidies to access cilostazol at a lower cost. Patient discussions reveal how crucial these subsidies can be, serving as a financial safety net that assures equitable access to this essential medication.

Clinicians are encouraged to embrace a patient-centred approach when prescribing cilostazol, taking into consideration individual circumstances and cultural aspects that might influence adherence to treatment.

Availability & Pricing Patterns

Cilostazol, marked as Pletal in Australia, is generally easy to find at major pharmacy chains, such as Chemist Warehouse, Priceline, and TerryWhite Chemmart. The competitive pharmacy landscape commonly keeps cilostazol affordable, especially for those who take advantage of PBS benefits.

The pricing of cilostazol varies significantly depending on whether patients utilise the PBS system or seek it privately. For instance:

• Under PBS, a co-payment makes cilostazol considerably more affordable for eligible patients.
• Private purchasing can lead to hefty costs, posing challenges to those without access to PBS.

The rise of online pharmacies and telehealth prescriptions offers convenient options for patients in both urban and rural communities. However, those preferring face-to-face consultations often face difficulties, sometimes needing to travel long distances for prescriptions.

By navigating these pathways effectively, patients can enjoy consistent access to cilostazol while staying informed on pricing strategies and assistance available.

City	Region	Delivery Time
Sydney	Nsw	5–7 days
Melbourne	Vic	5–7 days
Brisbane	Qld	5–7 days
Perth	Wa	5–7 days
Adelaide	Sa	5–7 days
Hobart	Tas	5–9 days
Canberra	Act	5–7 days
Darwin	Ntl	5–9 days
Gold Coast	Qld	5–9 days
Newcastle	Nsw	5–9 days
Coffs Harbour	Nsw	5–9 days
Geelong	Vic	5–9 days