From the Guidelines
Cilostazol can cause lightheadedness as a common side effect, and if you're experiencing it, you should not stop the medication abruptly but consult your healthcare provider. The lightheadedness occurs because cilostazol is a phosphodiesterase inhibitor that causes vasodilation, which can lower blood pressure and potentially reduce blood flow to the brain when changing positions 1. To manage this side effect, try changing positions slowly (especially when standing up from sitting or lying down), stay well-hydrated, and avoid alcohol which can worsen this effect. Your doctor might consider adjusting your dose (typically started at 100 mg twice daily), taking it with food to slow absorption, or evaluating for drug interactions that could be exacerbating this side effect 1. If lightheadedness is severe or accompanied by fainting, seek medical attention immediately as this could indicate a more serious reaction. Most patients develop some tolerance to this side effect over time as their body adjusts to the medication.
Managing Lightheadedness
Some key points to consider when managing lightheadedness caused by cilostazol include:
- Changing positions slowly to avoid sudden drops in blood pressure
- Staying well-hydrated to maintain blood volume
- Avoiding alcohol, which can exacerbate the effect
- Considering dose adjustments or taking the medication with food under the guidance of a healthcare provider
- Monitoring for severe lightheadedness or fainting, which requires immediate medical attention
Clinical Considerations
It's essential to weigh the benefits of cilostazol, such as improved symptoms and increased walking distance in patients with claudication, against the potential risks, including lightheadedness and other side effects 1. The decision to continue or adjust cilostazol should be made in consultation with a healthcare provider, considering the individual patient's response to the medication and their overall health status. For patients experiencing severe or persistent lightheadedness, alternative treatments or additional therapies to manage orthostatic hypotension may be considered, as discussed in the context of autonomic neuropathy management 1.
From the Research
Cilostazol and Lightheadedness
- Cilostazol is a phosphodiesterase III inhibitor with antiplatelet, antithrombotic, and vasodilatory effects, used to treat intermittent claudication 2.
- The most common adverse effects of cilostazol are headache, palpitation, tachycardia, abnormal stools, and diarrhea 2, 3.
- Dizziness is also reported as an adverse event in some studies, which may be related to lightheadedness 4, 5.
- The exact mechanism of cilostazol-induced lightheadedness is not well understood, but it may be related to its vasodilatory effects 6.
- Studies have shown that cilostazol is generally well tolerated, with most adverse events being mild to moderate in intensity 2, 3, 5.
- However, the frequency and severity of lightheadedness as an adverse event are not well characterized in the available studies.
Adverse Events
- Headache, diarrhea, abnormal stools, and palpitations are common adverse events associated with cilostazol 2, 3, 5.
- Dizziness and lightheadedness may also occur, although the frequency and severity are not well characterized 4, 5.
- Cilostazol is contraindicated in patients with congestive heart failure and severe hepatic or renal impairment 3.