Cilosol Special Precautions

Use with caution in patients receiving other platelet aggregation inhibitors or in patients with thrombocytopenia. Discontinue therapy if thrombocytopenia or leukopenia occur; progression to agranulocytosis (reversible) has been reported when cilostazol was not immediately stopped. When cilostazol and clopidogrel are used concurrently, manufacturer recommends checking bleeding times. Withhold for at least 4-6 half-lives prior to elective surgical procedures. Use with caution in patients receiving CYP3A4 inhibitors (eg, ketoconazole or erythromycin) or CYP2C19 inhibitors (eg, omeprazole). If concurrent use is warranted, consider dosage adjustment of cilostazol. Use with caution in severe underlying heart disease. Use caution in moderate-to-severe hepatic impairment. Use cautiously in severe renal impairment (Cl_cr <25 mL/minute). Safety and efficacy in pediatric patients have not been established.