Generic Pletal (Cilostazol)

Introduction

Pletal (cilostazol) is a phosphodiesterase-3 inhibitor prescribed primarily to improve walking distance in adults with intermittent claudication caused by peripheral arterial disease (PAD). The medication is manufactured by Bayer in tablet form and is supplied in two strengths: 50 mg and 100 mg. Cilostazol belongs to the antiplatelet/vasodilator class, and while its approved use is limited to PAD-related claudication, clinicians occasionally consider it for several off-label indications that have emerged from clinical research.

What is Pletal?

Pletal is a trade name for the active compound cilostazol, a synthetic derivative of the quinolinone family. It was first approved in the United States in 1999 after extensive Phase III trials demonstrated efficacy in increasing pain-free walking distance for patients with PAD. Bayer AG is the original developer and commercial holder of the brand. Cilostazol is also marketed under other names such as Celphyl and Vasodil® in various countries, reflecting its global availability.

Pletal is the generic version of well-known medications, containing the active compound cilostazol. Our online pharmacy provides this generic alternative as a cost-effective treatment option.

How Pletal Works

Cilostazol selectively inhibits phosphodiesterase-3 (PDE3), an enzyme responsible for breaking down cyclic adenosine monophosphate (cAMP) in vascular smooth-muscle cells and platelets. By raising intracellular cAMP levels, the drug produces two complementary effects:

1. Vasodilation - cAMP-mediated relaxation of arterial smooth muscle expands peripheral vessels, improving blood flow to ischemic limb muscles.
2. Antiplatelet activity - elevated cAMP interferes with platelet aggregation, reducing micro-thrombus formation that could further compromise limb perfusion.

The onset of vasodilatory action occurs within a few hours after the first dose, while the antiplatelet effect stabilises after approximately 2 days of consistent dosing. Cilostazol has a half-life of 11-13 hours, allowing twice-daily administration to maintain therapeutic plasma concentrations.

Conditions Treated with Pletal

Intermittent Claudication (Peripheral Arterial Disease)

Approved indication (FDA, EMA) - Cilostazol is indicated to increase maximal and pain-free walking distance in adults with intermittent claudication secondary to PAD. The drug improves distal arterial blood flow and reduces the frequency of ischemic pain episodes, enabling patients to engage more fully in supervised exercise programs and daily activities.

Off-Label and Investigational Uses of Pletal

• Raynaud’s Phenomenon - Small uncontrolled studies have reported reduced frequency of vasospastic attacks when cilostazol is added to standard calcium-channel blocker therapy. Evidence remains limited and does not constitute regulatory approval.
• Secondary Stroke Prevention - A 2015 meta-analysis of observational cohorts suggested a modest reduction in recurrent ischemic stroke among patients receiving cilostazol compared with aspirin. Randomised data are insufficient for an official indication.
• Prevention of Restenosis after Angioplasty - Early-phase trials in coronary and peripheral arterial interventions have explored cilostazol’s antiproliferative effects on vascular smooth-muscle cells, showing lower restenosis rates in select populations.
• Diabetic Foot Ulcer Healing - Pilot trials indicate that improved microcirculation may accelerate ulcer closure, yet larger, controlled studies are required.

These off-label applications are not approved by regulatory agencies. Patients should discuss any such use exclusively with a qualified healthcare professional.

Is Pletal the Right Medication for You?

Cilostazol is most appropriate for adults who:

• Have documented intermittent claudication due to PAD and can ambulate at least 50 m without assistive devices.
• Do not have a history of congestive heart failure (NYHA class III-IV) or recent myocardial infarction.
• Possess adequate hepatic function (Child-Pugh A-B) and renal function (eGFR ≥ 30 mL/min/1.73 m²).

Contraindications include:

• Congestive heart failure (any class)
• Active bleeding or known bleeding diathesis
• Recent (≤ 3 months) stroke or transient ischemic attack
• Uncontrolled hypertension (≥ 180/110 mm Hg)
• Pregnancy, lactation, or women of child-bearing potential not using reliable contraception
• Severe hepatic impairment (Child-Pugh C)

Patients with these conditions should avoid cilostazol or seek alternative therapies.

Risks, Side Effects, and Interactions

Common

• Headache
• Diarrhoea or loose stools
• Palpitations or tachycardia
• Dizziness

These events are typically mild, transient, and resolve with continued therapy or dose adjustment.

Rare

• Peripheral edema
• Nausea or vomiting
• Elevated liver enzymes (ALT, AST)

Routine laboratory monitoring is advisable, especially during the initial 3 months of treatment.

Serious

• Heart failure exacerbation - Cilostazol can increase ventricular filling pressures; any sign of dyspnoea, weight gain, or oedema warrants immediate medical review.
• Severe hypotension - Marked blood-pressure decline may occur when combined with other vasodilators.
• Bleeding complications - Though antiplatelet, bleeding is uncommon; however, concomitant use with anticoagulants (e.g., warfarin, DOACs) can magnify risk.

Drug-Drug and Drug-Food Interactions

• CYP3A4 and CYP2C19 inhibitors (e.g., itraconazole, fluconazole, omeprazole) increase cilostazol plasma concentrations; dose reduction may be necessary.
• CYP3A4 inducers (e.g., carbamazepine, rifampicin, St. John’s wort) lower exposure, potentially reducing efficacy.
• Anticoagulants / antiplatelet agents - additive bleeding risk; monitor coagulation parameters closely.
• Alcohol - potentiates vasodilatory effects and may exacerbate dizziness; moderation is advised.

Use: Dosing, Missed Dose, Overdose

• Standard initiation: 50 mg orally twice daily (morning and early evening) taken with food to improve absorption and reduce gastrointestinal irritation.
• Titration: After 2 weeks, if tolerated, the dose may be increased to 100 mg twice daily for greater walking-distance benefit.
• Missed dose: If a dose is forgotten and the next scheduled dose is more than 6 hours away, take the missed tablet. If the next dose is imminent, skip the missed dose; do not double-dose.
• Overdose: Acute overdose may present with severe hypotension, prolonged tachycardia, and gastrointestinal upset. Seek emergency medical care; supportive measures (intravenous fluids, monitoring) are the mainstay of management.
• Administration tips: Swallow tablets whole with a glass of water; avoid crushing. Alcohol should be limited, and patients should refrain from operating heavy machinery until they know how cilostazol affects them.

FAQ

• What should I do with Pletal when traveling internationally? Store the tablets in their original packaging, protected from heat and moisture. Carry a copy of the prescription or a physician’s letter if required by customs.

• Does grapefruit juice affect cilostazol? Yes. Grapefruit inhibits CYP3A4, raising cilostazol levels and increasing the risk of side effects. It is best to avoid large amounts while on therapy.

• How do the tablets look, and are there any inactive ingredients I should be aware of? Pletal tablets are white, round, and film-coated. In components include lactose, microcrystalline cellulose, and magnesium stearate. Patients with lactose intolerance should discuss alternatives with their provider.

• Can I store Pletal in a bathroom cabinet? The tablets should be kept at 20-25 °C (68-77 °F) and protected from excess humidity. A bathroom cabinet is acceptable if the environment remains dry; otherwise, a cooler, dry place is preferred.

• Will cilostazol show up on a standard drug test? Cilostazol is not typically screened for in routine employment or sports drug tests. Specialized assays can detect it, but it is not listed among prohibited substances in most sporting federations.

• Is there a difference in effectiveness between brand-name Pletal and generic cilostazol? Both contain the same active ingredient and are required to meet identical bioequivalence standards. Clinical outcomes are expected to be comparable when the generic is sourced from reputable manufacturers.

• How long before I notice improvement in walking distance? Most patients report a measurable increase in pain-free walking distance after 2-4 weeks of consistent dosing, with maximal benefit often observed at 12 weeks.

• **Can I take Pletal with a statin Yes. No clinically significant interaction has been documented between cilostazol and commonly used statins such as atorvastatin or rosuvastatin. Nonetheless, routine monitoring of lipid panels remains advisable.

• What is the impact of cilostazol on blood pressure? Cilostazol can cause mild vasodilation, leading to a modest reduction in systolic blood pressure (≈ 3-5 mm Hg). Patients with already low blood pressure should be monitored for symptoms of dizziness.

• Is it safe to start exercise therapy while on Pletal? Yes. Cilostazol is most effective when combined with a supervised walking program. Exercise enhances collateral vessel development and maximizes functional gains.

• Does cilostazol interact with hormonal contraceptives? No evidence suggests a pharmacokinetic or pharmacodynamic interaction; however, patients should still use reliable contraception because the drug is contraindicated in pregnancy.

Glossary

Phosphodiesterase-3 (PDE3)

An enzyme that degrades cyclic adenosine monophosphate (cAMP) in vascular smooth-muscle cells and platelets; inhibition leads to vasodilation and antiplatelet effects.

Intermittent Claudication

Exercise-induced muscle pain (usually in the calves) caused by insufficient blood flow due to peripheral arterial disease; relieved by rest.

Antiplatelet

A class of that prevents platelets from clumping together, thereby reducing the risk of thrombus (clot) formation.

Half-Life

The time required for the plasma concentration of a drug to decrease by 50 %; for cilostazol this is approximately 11 - 13 hours, supporting twice-daily dosing.

Buying Pletal from Our Online Pharmacy

Patients who encounter limited access, high out-of-pocket costs, or long waiting periods at conventional pharmacies can obtain cilostazol conveniently through our online pharmacy. We source the medication from licensed, internationally accredited suppliers, ensuring that each batch meets stringent quality-control standards equivalent to those required by regulatory agencies.

Because we operate as a pharmacy-broker service, we are able to offer near-manufacturer pricing, reducing the financial burden for individuals seeking an affordable generic alternative. Orders are processed discreetly; packages are packaged in unbranded, tamper-evident envelopes and delivered via a range of shipping options, from express (typically 7 days) to standard airmail (approximately 3 weeks).

Our platform emphasizes privacy-personal data is encrypted, and delivery details are limited to the essential information required for shipment. By partnering with verified overseas pharmacies, we provide a reliable pathway for patients who might otherwise face barriers to obtaining cilostazol.

Disclaimer

The information presented about Pletal is intended solely for general educational purposes and does not substitute individualized medical advice. Treatment decisions, including any consideration of off-label use, must be made under the direct supervision of a qualified healthcare professional. Readers are presumed to be competent adults capable of making informed health choices. Our online pharmacy offers access to Pletal for individuals who may experience limited availability through traditional channels or who seek a cost-effective generic alternative. Always discuss any medication changes with your clinician before initiating, adjusting, or discontinuing therapy.