Drug interactions
Cilostazol + Fluoxetine
Severity: Moderate
Cilostazol and Fluoxetine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fluoxetine and its metabolite norfluoxetine inhibit CYP2C19 and also CYP3A4 to a lesser extent, which can raise exposure to cilostazol and its active metabolite. This may increase cilostazol adverse effects such as headache, tachycardia, palpitations and diarrhoea.
What this interaction means in plain words
Cilostazol and Fluoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cilostazol belongs to Cardiovascular; Fluoxetine belongs to Central Nervous System.
Why it happens
Inhibition of CYP2C19 (and weaker CYP3A4) by fluoxetine reduces cilostazol metabolism.
What to do
Labeling advises considering a lower cilostazol dose (50 mg twice daily) with potent or moderate CYP2C19 inhibitors. Monitor for tachycardia, palpitations and headache.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Cilostazol
Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Cilostazol with Fluoxetine?
MediHelp rates the interaction as moderate. Cilostazol and Fluoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluoxetine and its metabolite norfluoxetine inhibit CYP2C19 and also CYP3A4 to a lesser extent, which can raise exposure to cilostazol and its active metabolite. This may increase cilostazol adverse effects such as headache, tachycardia, palpitations and diarrhoea.
How serious is the interaction between Cilostazol and Fluoxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Labeling advises considering a lower cilostazol dose (50 mg twice daily) with potent or moderate CYP2C19 inhibitors. Monitor for tachycardia, palpitations and headache.
What other medicines interact with Cilostazol?
MediHelp also lists interactions of Cilostazol with, for example, Abrocitinib, Anagrelide, Betrixaban. The full list is on the Cilostazol page.
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