Buy Generic Pletal Online

Generic Pletal Information

Introduction

Pletal (generic name: cilostazol) is a phosphodiesterase‑3 (PDE‑3) inhibitor approved for the improvement of walking distance in patients with intermittent claudication secondary to peripheral arterial disease (PAD). In Hong Kong, the drug is prescribed by vascular specialists and cardiologists to alleviate leg pain caused by reduced blood flow. The active compound, cilostazol, belongs to the general‑health medication group, reflecting its role in enhancing microcirculation and platelet function. While its primary indication is PAD, cilostazol is also explored for secondary uses such as secondary prevention after ischemic stroke and for certainvascular complications, though these are not formally approved in Hong Kong.

What is Pletal?

Pletal is a tablet formulation that contains 100 mg of cilostazol as the sole active ingredient. It is marketed by Celgene Corporation (now part of Bristol‑Myers Squibb) and has been registered with the Hong Kong Department of Health under the brand name “Pletal.” Cilostazol was originally developed in the 199s as an antiplatelet and vasodilator agent and received U.S. FDA approval in 1999. In Hong Kong, the medication is classified as a prescription‑only drug and is dispensed by licensed pharmacies following a physician’s order.

How Pletal Works

Cilostazol inhibits the enzyme phosphodiesterase‑3, leading to an increase in intracellular cyclic adenosine monophosphate (cAMP) within vascular smooth‑muscle cells and platelets. Elevated cAMP produces two therapeutic effects:

• Vasodilation: Relaxation of peripheral arteries improves blood flow to the lower limbs, reducing the ischemic pain that limits walking distance.
• Antiplatelet activity: cAMP suppresses platelet aggregation, lowering the risk of micro‑thrombus formation that can exacerbate PAD.

The drug reaches peak plasma concentrations 2–4 hours after oral administration, and its half‑life is approximately 11–13 hours, allowing for twice‑daily dosing. Cilostazol is metabolized primarily by CYP3A4 and CYP2C19, with renal excretion accounting for about 30 % of the eliminated drug.

Conditions Treated with Pletal

• Intermittent Claudication (Peripheral Arterial Disease): The FDA‑approved and Hong Kong‑registered indication. Clinical trials have demonstrated a 30–50 % increase in maximal walking distance after 12 weeks of therapy.
• Secondary Prevention of Non‑Cardioembolic Ischemic Stroke (off‑label): Some Asian guidelines reference cilostazol as an alternative to aspirin due to a lower hemorrhagic risk, though it is not formally approved for this use in Hong Kong.
• Microvascular Complications in Diabetes (investigational): Early studies suggest potential benefits in improving peripheral microcirculation, but evidence remains limited.

In Hong Kong, PAD prevalence rises with age and diabetes, affecting an estimated 5–7 % of adults over 60. Prompt treatment with cilostazol can improve functional capacity and quality of life for these patients.

Who is Pletal For?

• Adults with symptomatic intermittent claudication whose ankle‑brachial index (ABI) is ≤.90 and who can tolerate oral therapy.
• Patients who have failed or are intolerant to walking rehabilitation alone, as cilostazol adds a pharmacologic component to improve outcomes.
• Individuals without significant cardiac failure (NYHA class III/IV), uncontrolled hypertension, or recent myocardial infarction, because cilostazol can increase heart rate and ventricular contractility.
• Patients not on contraindicated medications such as strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole) or other PDE‑3 inhibitors.

Contraindications include severe hepatic impairment, active bleeding, recent stroke within 3 months, and known hypersensitivity to cilostazol. Pregnant or breastfeeding women should avoid the drug, as safety data are lacking.

Risks, Side Effects, and Interactions

Common

• Headache
• Diarrhea or loose stools
• Palpitations or increased heart rate
• Dizziness, especially upon standing

These events are usually mild to moderate and often resolve within the first few weeks of therapy.

Rare

• Dyspepsia or abdominal pain
• Rash or pruritus
• Mild elevations in liver enzymes (ALT/AST)

Patients should notify their clinician if any of these symptoms persist or worsen.

Serious

• Bleeding complications: Although cilostazol has antiplatelet effects, severe gastrointestinal bleeding has been reported, particularly in patients with ulcer disease or concurrent anticoagulant use.
• Cardiac arrhythmias or myocardial ischemia: Rare cases of ventricular tachycardia and angina have been noted, especially in patients with pre‑existing coronary artery disease.
• Severe hepatic impairment: Accumulation of the drug can lead to toxicity.

Any signs of chest pain, unusual bruising, or persistent dizziness warrant immediate medical attention.

Clinically Relevant Drug–Drug Interactions

• Strong CYP3A4 inhibitors (e.g., itraconazole, ritonavir) increase cilostazol plasma levels, raising the risk of adverse events.
• Strong CYP2C19 inhibitors (e.g., fluoxetine, omeprazole) have a similar effect.
• Concurrent anticoagulants (warfarin, direct oral anticoagulants) amplify bleeding risk.
• Other antiplatelet agents (aspirin, clopidogrel) may produce additive platelet inhibition.

Patients should provide a complete medication list to their prescriber before initiating Pletal.

Practical Use: Dosing, Missed Dose, Overdose

• Standard dosing: 100 mg taken orally twice daily (morning and evening) with food to reduce gastrointestinal upset.
• Dose adjustment: No routine adjustment is required for mild to moderate renal impairment; however, severe hepatic dysfunction warrants avoidance.
• Missed dose: If a dose is missed by less than 8 hours, take it as soon as remembered. If more than 8 hours have elapsed, skip the missed dose and resume the regular schedule. Do not double‑dose.
• Overdose: Symptoms may include severe nausea, vomiting, dizziness, and tachycardia. Seek urgent medical care; activated charcoal may be considered if presentation is within one hour of ingestion.

Precautions: Avoid excessive alcohol, as it can potentiate vasodilatory effects and increase dizziness. Grapefruit juice should be avoided because it inhibits CYP3A4 and may raise cilostazol concentrations.

Buying Pletal from Our Online Pharmacy

Patients in Hong Kong seeking a reliable source for cilostazol can purchase Pletal from our online pharmacy. Our service offers

• Affordable pricing: Near‑manufacturer cost, typically 15–20 % lower than local retail pharmacies.
• Verified quality: All batches are sourced from licensed overseas manufacturers who comply with GMP standards and are inspected by international regulatory agencies.
• Guaranteed delivery: Discreet packaging with express shipping (delivery within 7 days) or regular airmail (approximately 3 weeks). Tracking is provided for every order.
• Online‑only access: We specialize in international medications that may have limited local availability, delivering them directly to your doorstep while maintaining strict privacy protections.

Our pharmacy operates as a broker service, collaborating with accredited overseas pharmacies to ensure authenticity and regulatory compliance. This model enables patients with limited insurance coverage or those who prefer a cost‑effective alternative to obtain Pletal safely.

FAQ

• Can Pletal be taken with other antiplatelet drugs such as aspirin?
  Co‑administration is possible but increases bleeding risk. Physicians usually assess the benefit‑risk ratio before combining these agents, and dose adjustments may be necessary.

• Does cilostazol require refrigeration?
  No. Pletal tablets should be stored at room temperature, between 20 °C and 25 °C, protected from moisture and direct sunlight.

• What does the tablet look like, and how is it packaged?
  Each tablet is round, bicolored (typically white and blue), and carries the imprint “CIL 100.” In Hong Kong, tablets are supplied in blister packs of 30 tablets, with a labeled outer box indicating strength and expiry date.

• Are there differences in formulation between the US, EU, and Asian markets?
  The active ingredient, cilostazol 100 mg, is consistent globally. Inactive excipients (e.g., lactose, magnesium stearate) may vary slightly to meet regional regulatory standards, but therapeutic efficacy remains unchanged.

• Can I travel internationally with Pletal, and are there customs restrictions?
  Yes, provided you carry a copy of the prescription and the original packaging. Hong Kong allows personal import of up to a 30‑day supply for personal use, but you should declare the medication at customs when entering other jurisdictions.

• How does cilostazol affect blood pressure?
  Cilostazol can cause a modest reduction in systolic blood pressure due to vasodilation, typically 2–5 mm . Patients on antihypertensive therapy should monitor their readings, especially during the first weeks of treatment.

• What is the mechanism behind cilostazol‑induced headache?
  The vasodilatory effect on cerebral vessels increases blood flow, which can stimulate nociceptive pathways and result in headache. Taking the medication with food often reduces this side effect.

• Is there a generic version of Pletal available in Hong Kong?
  Yes. Generic cilostazol tablets contain the same active ingredient and strength as Pletal. They are marketed under various trade names by local distributors, offering a lower-cost alternative while maintaining bioequivalence.

• Can Pletal be used in patients with mild liver disease?
  Cilostazol is metabolized in the liver; mild hepatic impairment (Child‑Pugh A) does not require dose reduction, but liver function should be monitored periodically. Severe hepatic dysfunction is a contraindication.

• Does smoking influence the effectiveness of cilostazol?
  Smoking worsens peripheral arterial disease and may diminish the clinical benefit of cilostazol by perpetuating endothelial dysfunction. Smoking cessation is strongly recommended to maximize therapeutic outcomes.

• What should I do if I experience a severe rash while taking Pletal?
  Stop the medication immediately and seek medical attention. A rash could indicate an allergic reaction, and re‑challenge with the drug is generally contraindicated.

• Are there any dietary restrictions while on cilostazol?
  Avoid large quantities of grapefruit juice, as it can inhibit CYP3A4 metabolism and raise drug levels. Otherwise, a normal balanced diet is acceptable.

Glossary

Phosphodiesterase‑3 (PDE‑3) Inhibitor

A class of drugs that block the PDE‑3 enzyme, leading to higher intracellular cAMP and resulting in vasodilation and antiplatelet effects.

Ankle‑Brachial Index (ABI)

A non‑invasive test that compares blood pressure in the ankle with that in the arm; values ≤.90 indicate peripheral arterial disease.

CYP3A4

A liver enzyme that metabolizes many medications, including cilazol; inhibitors of this enzyme can increase drug concentrations.

Intermittent Claudication

Exercise‑induced muscle pain (typically in the calves) caused by insufficient blood flow due to peripheral arterial narrowing.

⚠️ Disclaimer

The information provided about Pletal is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Pletal for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.