Drug interactions
Cilostazol + Ticlopidine
Severity: Major
Cilostazol and Ticlopidine: major 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
Ticlopidine inhibits CYP2C19 and raises exposure to cilostazol's active metabolites, increasing risks such as headache, tachycardia and bleeding. Both drugs impair platelet function, adding to bleeding risk.
What this interaction means in plain words
Cilostazol and Ticlopidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Cilostazol belongs to Cardiovascular; Ticlopidine belongs to Cardiovascular.
Why it happens
CYP2C19 inhibition reduces cilostazol metabolism, plus additive antiplatelet effects.
What to do
Reduce the cilostazol dose to 50 mg twice daily per labeling when given with strong CYP2C19 inhibitors. Monitor for bleeding, palpitations and headache.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ticlopidine
Other interactions of Cilostazol
Frequently asked questions
Can I take Cilostazol with Ticlopidine?
MediHelp rates the interaction as major. Cilostazol and Ticlopidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ticlopidine inhibits CYP2C19 and raises exposure to cilostazol's active metabolites, increasing risks such as headache, tachycardia and bleeding. Both drugs impair platelet function, adding to bleeding risk.
How serious is the interaction between Cilostazol and Ticlopidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the cilostazol dose to 50 mg twice daily per labeling when given with strong CYP2C19 inhibitors. Monitor for bleeding, palpitations and headache.
What other medicines interact with Ticlopidine?
MediHelp also lists interactions of Ticlopidine with, for example, Mavacamten, Abrocitinib, Acetylsalicylic acid. The full list is on the Ticlopidine page.
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