Pletal and Food

Take cilostazol on an empty stomach 1 hour before or 2 hours after a meal unless otherwise directed by your doctor. Food may reduce the absorption of cilostazol. Taking cilostazol on an empty stomach will make it easier for your body to absorb the medication. If you are receiving therapy with cilostazol you should avoid grapefruits and grapefruit juice. Grapefruit can raise the levels of cilostazol in your body and lead to dangerous side effects. You may experience headache, dizziness, chest pain, feeling short of breath, and swelling of your ankles or feet. Call your doctor at once if you have any of these symptoms.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of cilostazol. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.

MANAGEMENT: Until more information is available, the manufacturer recommends avoiding consumption of grapefruit juice during cilostazol therapy. Orange juice is not expected to interact with cilostazol.