Cilostazol (Pletal) — What it is and who it helps

Ever been stopped in your tracks by leg pain while walking? Cilostazol is a prescription drug many people use to relieve that specific pain and increase how far they can walk. It’s not a cure, but for people with peripheral artery disease (PAD) and intermittent claudication, it can make daily activities easier.

How cilostazol works and when it’s used

Cilostazol is a pill that helps widen blood vessels and reduce platelets’ tendency to clump. That means better blood flow to the legs. Doctors prescribe it mainly for intermittent claudication — the cramp-like pain or tiredness in calves, thighs, or buttocks that happens while walking and improves with rest. It’s used alongside exercise therapy and other medical care, not as a lone fix.

How to take cilostazol

The usual dose is 100 mg twice a day. Take it about 30 minutes before a meal or at least 2 hours after eating, unless your doctor says otherwise. Keep to a regular schedule and don’t stop suddenly without talking to your provider. If you miss a dose, take it as soon as you remember unless it’s almost time for the next one — don’t double up.

Be honest with your doctor about all other medicines you take. Cilostazol is broken down by liver enzymes (CYP3A4 and CYP2C19). Strong inhibitors — like certain antifungals, some antibiotics, and some HIV drugs — can raise cilostazol levels and increase side effects. Grapefruit and grapefruit juice can also interfere with metabolism, so avoid them while on this drug.

Common side effects & important warnings

Some side effects are mild: headache, diarrhea, dizziness, and fast heartbeat are the most common. If you feel chest pain, faint, or experience severe shortness of breath, get medical help right away. Cilostazol should not be used by people with heart failure of any kind — that’s a strict contraindication because it can make heart failure worse.

The drug can affect bleeding risk, so tell your doctor if you’re on blood thinners, aspirin, or other antiplatelet drugs. Pregnant or breastfeeding people should discuss risks and alternatives — data is limited.

Practical tips: combine cilostazol with a supervised walking program and lifestyle changes such as quitting smoking, controlling blood sugar, blood pressure, and cholesterol. These steps often boost results more than medicine alone. Keep routine follow-ups so your provider can watch for side effects and check if the drug is helping.

If cilostazol isn’t working or causes bothersome effects, there are other medical and procedural options for PAD — ask your vascular specialist what fits your situation. When used correctly, cilostazol can be a useful tool to help you move more comfortably and get back to everyday life.