From the Research
Cilostazol may be prescribed off-label for Raynaud's phenomenon at a typical dose of 100 mg twice daily, as evidenced by a study published in 2003 1. The medication should be taken on an empty stomach, at least 30 minutes before or 2 hours after meals. For Raynaud's specifically, patients often start at this dose, with potential adjustment based on tolerance and response. Treatment duration is typically ongoing during cold seasons or year-round depending on symptom severity. Cilostazol works by inhibiting phosphodiesterase, which leads to vasodilation and reduced platelet aggregation, potentially improving blood flow to the fingers and toes affected by Raynaud's. Common side effects include headache, diarrhea, and dizziness. This medication is contraindicated in patients with heart failure, and should be used cautiously in those with cardiovascular disease. Patients should continue other Raynaud's management strategies like keeping extremities warm and avoiding triggers while using this medication.
Some key points to consider when prescribing cilostazol for Raynaud's phenomenon include:
- The medication's efficacy in improving blood flow and reducing symptoms, as seen in the 2003 study 1
- The potential for side effects, such as headache and diarrhea, and the need for careful monitoring and adjustment of the dose as needed
- The importance of continuing other management strategies, such as keeping extremities warm and avoiding triggers, to maximize the effectiveness of the medication
- The need for caution when prescribing cilostazol to patients with cardiovascular disease or other underlying health conditions, as noted in the 2021 review 2
It's worth noting that while cilostazol may be effective in improving symptoms of Raynaud's phenomenon, it is not FDA-approved for this indication, and other treatments, such as calcium channel blockers and phosphodiesterase 5 inhibitors, may also be considered, as discussed in the 2018 review 3.