Vaxol Drug Interactions

Cilostazol may enhance the effects of anticoagulant and antiplatelet agents. Antifungal drugs (e.g. imidazole) may decrease the metabolism of cilostazol via the CYP isoenzymes. CYP2C19 inhibitors (e.g. delavirdine, fluvoxamine, gemfibrozil, isoniazid, omeprazole, and ticlopidine) and CYP3A4 inhibitors (e.g. azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, quinidine, telithromycin, and verapamil) could increase the levels and effects of cilostazol. A reduction of dose to 50 mg twice daily is recommended. CYP3A4 inducers (aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins) may decrease the levels or effects of cilostazol. A reduction to 50 mg twice daily is also recommended. Dasatinib may enhance the antithrombotic effects of cilostazol. Macrolide antibiotics (e.g. clarithromycin, erythromycin, telithromycin) may decrease the metabolism, via CYP isoenzymes, of cilostazol. Nonsteroidal anti-inflammatory drugs and salicylates may enhance the adverse or toxic effects of antiplatelet agents thereby an increased risk of bleeding may occur. Omega-3-acid ethyl esters may enhance the effect of antiplatelet agents. Omeprazole and treprostinil may enhance the adverse or toxic effects of cilostazol. Avoid concurrent ingestion of grapefruit juice due to the potential to inhibit CYP3A4.