What is the purpose of Pletal (Cilostazol) with an exercise regimen?

From the Guidelines

Pletal (cilostazol) combined with an exercise regimen is primarily used to treat intermittent claudication, a condition characterized by leg pain during walking due to poor blood circulation, with the goal of improving symptoms and increasing walking distance. The typical dosage is 100 mg twice daily, taken 30 minutes before or 2 hours after meals. This medication works by inhibiting phosphodiesterase enzymes, which helps prevent platelet aggregation and promotes vasodilation, improving blood flow to the legs. Some key points to consider when using Pletal (cilostazol) include:

• The exercise component typically involves a structured walking program where patients walk until moderate pain develops, rest until pain subsides, then resume walking.
• This should be done for 30-45 minutes per session, 3-5 times weekly, gradually increasing duration and intensity as tolerated.
• The combination of Pletal and exercise is more effective than either alone, as exercise helps develop collateral circulation while the medication improves existing blood flow.
• Patients should avoid grapefruit juice while taking Pletal and should be aware that common side effects include headache, diarrhea, and dizziness.
• This treatment approach typically shows improvement in walking distance after 2-4 weeks, though maximum benefits may take 12 weeks to develop, as supported by studies such as 1. It's also important to note that cilostazol is contraindicated in patients with heart failure, and its use should be weighed against potential benefits and risks, including adverse effects and cost, as discussed in 1.

From the FDA Drug Label

Cilostazol tablets are indicated for the reduction of symptoms of intermittent claudication, as indicated by an increased walking distance. The purpose of Pletal (Cilostazol) with an exercise regimen is to reduce symptoms of intermittent claudication, as evidenced by an increased walking distance 2.

• The main goal is to improve walking distance in patients with intermittent claudication.
• Cilostazol is used in conjunction with an exercise regimen to achieve this goal.

From the Research

Purpose of Pletal (Cilostazol) with an Exercise Regimen

The purpose of Pletal (Cilostazol) with an exercise regimen is to improve walking distance in patients with intermittent claudication. Key points include:

• Cilostazol is a phosphodiesterase-3 inhibitor that has been shown to increase pain-free and maximum walking distance in patients with intermittent claudication 3, 4, 5.
• The medication is typically administered at a dose of 100 mg twice daily, and its effects are seen as early as 2 weeks after initiation of therapy 3, 6, 5.
• Cilostazol is generally well tolerated, with common adverse effects including headache, diarrhea, and abnormal stools 4, 5.
• The use of cilostazol in combination with an exercise regimen is supported by studies that demonstrate its efficacy in improving walking distance and quality of life in patients with intermittent claudication 3, 4, 6, 5, 7.

Benefits of Cilostazol with Exercise

Benefits of using cilostazol with an exercise regimen include:

• Improved walking distance: Cilostazol has been shown to increase both pain-free and maximum walking distance in patients with intermittent claudication 3, 4, 6, 5.
• Enhanced quality of life: By improving walking distance and reducing symptoms of intermittent claudication, cilostazol can enhance overall quality of life for patients with this condition 4, 7.
• Low risk of adverse effects: Cilostazol is generally well tolerated, with most adverse effects being mild to moderate in intensity 4, 5.

Comparison to Other Treatments

Cilostazol has been compared to other treatments for intermittent claudication, including:

• Pentoxifylline: Cilostazol has been shown to be more effective than pentoxifylline in improving walking distance and quality of life in patients with intermittent claudication 4, 6.
• Exercise therapy: While exercise therapy is an important component of treatment for intermittent claudication, cilostazol has been shown to provide additional benefits in terms of improved walking distance and quality of life 3, 4, 7.