2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

. Author manuscript; available in PMC: 2017 Sep 21.

Published in final edited form as: Circulation. 2016 Nov 13;135(12):e726–e779. doi: 10.1161/CIR.0000000000000471


Recommendation for Cilostazol

COR	LOE	Recommendation

I	A	Cilostazol is an effective therapy to improve symptoms and increase walking distance in patients with claudication.^199,200

See Online Data Supplement 25.		In a Cochrane review including 15 double-blind RCTs with a total of 3718 participants, cilostazol was associated with improvement in claudication symptoms but no changes in cardiovascular deaths or QoL when compared with placebo.¹⁹⁹ In 1 RCT, cilostazol was more effective than pentoxifylline or placebo.²⁰⁰ Side effects include headache, abnormal stool (diarrhea), dizziness, and palpitations. Cilostazol is contraindicated in patients with congestive heart failure.²⁰¹ In 1 trial, 20% of patients discontinued cilostazol within 3 months.²⁰²