Drug General Information (ID: DDILBUYH1A)
Drug Name			Dipyridamole		Drug Info		Cilostazol		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vasodilator Agents				Vasodilator Agents
Structure

Mechanism of Dipyridamole-Cilostazol Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Dipyridamole				Cilostazol
Mechanism		Risk of bleeding Antiplatelet				Risk of bleeding Antiplatelet
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Dipyridamole and Cilostazol

Recommended Action
Management		Because of theoretical concerns regarding increased inhibition of platelet aggregation, cilostazol should be used cautiously with other antiplatelet agents.

References
1	Product Information. Pletal (cilostazol). Otsuka American Pharmaceuticals, Rockville, MD.
2	Wilhite DB, Comerota AJ, Schmieder FA, Throm RC, Gaughan JP, Rao AK "Managing PAD with multiple platelet inhibitors: the effect of combination therapy on bleeding time." J Vasc Surg 38 (2003): 710-3
3	Mallikaarjun S, Forbes WP, Bramer SL "Interaction potential and tolerability of the coadministration of cilostazol and aspirin." Clin Pharmacokinet 37 (1999): 87-93