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In a single-dose clinical studyno inhibition of the metabolism of warfarin or an effect on the coagulation parametersPTaPTTbleeding timewas observedHowevercaution is advised in patients receiving both cilostazol and any anticoagulant agentand frequent monitoring is required to reduce the possibility of bleeding.

A priming dose of ketoconazole 400 mga strong inhibitor of CYP3A4was given one day prior to coadministration of single doses of ketoconazole 400 mg and cilostazol 100 mgThis regimen increased cilostazol C max by 94and AUC by 117Other strong inhibitors of CYP3A4such as itraconazolevoriconazoleclarithromycinritonavirsaquinavirand nefazodone would be expected to have a similar effectsee Dosage and Administration2.2Drug Interactions7.1

Administration of cilostazol with omeprazolean inhibitor of CYP2C19increased the AUC of cilostazol by 22accompanied by a 68increase in the AUC of the dehydro metabolite and a decrease of 36in the AUC of the 4trans hydroxy metaboliteBased on AUCthe overall pharmacological activity increases by 47when co-administered with omeprazoleBased on these datathe recommended dose of cilostazol is 50 mg bid in the presence of omeprazole.

Reduce dose to 50 mg twice daily when coadministered with strong or moderate inhibitors of CYP3A4e.gketoconazoleitraconazoleerythromycinand diltiazemor inhibitors of CYP2C19e.gticlopidinefluconazoleand omeprazolesee Drug Interactions7.1

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