Cilostazol (Greater Than 50 mg)/Fluoxetine; Fluvoxamine Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process cilostazol properly. Both of these medicines may increase your risk of bleeding.

What might happen:

Your blood levels of cilostazol may increase and cause harmful effects. Taking these medicines together may also increase your risk of bleeding.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you have any signs of bleeding such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools. Contact your doctor if you experience headache; diarrhea; dizziness; or bloating or swelling of the ankles, feet, or hands. The dose of your medicines may need adjusting.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Pletal (cilostazol) US prescribing information. Otsuka America Pharmaceutical, Inc. January, 2015.
  • 2.Prozac (fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company August, 2023.
  • 3.Luvox (fluvoxamine maleate) US prescribing information. Jazz Pharmaceuticals, Inc. August, 2023.
  • 4.Suri A, Bramer SL. Effect of omeprazole on the metabolism of cilostazol. Clin Pharmacokinet 1999;37 Suppl 2:53-9.
  • 5.Iwagami M, Tomlinson LA, Mansfield KE, Douglas IJ, Smeeth L, Nitsch D. Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study. Br J Clin Pharmacol 2018 Sep;84(9):2142-2151.
  • 6.de Abajo FJ, Rodriguez LA, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study. BMJ 1999 Oct 23;319(7217):1106-9.
  • 7.Schalekamp T, Klungel OH, Souverein PC, de Boer A. Increased bleeding risk with concurrent use of selective serotonin reuptake inhibitors and coumarins. Arch Intern Med 2008 Jan 28;168(2):180-5.
  • 8.Labos C, Dasgupta K, Nedjar H, Turecki G, Rahme E. Risk of bleeding associated with combined use of selective serotonin reuptake inhibitors and antiplatelet therapy following acute myocardial infarction. CMAJ 2011 Nov 8;183(16):1835-43.
  • 9.Teichert M, Visser LE, Uitterlinden AG, Hofman A, Buhre PJ, Straus S, De Smet PA, Stricker BH. Selective serotonin reuptake inhibiting antidepressants and the risk of overanticoagulation during acenocoumarol maintenance treatment. Br J Clin Pharmacol 2011 May 4.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.