Nilotinib with Cilostazol Interaction Details


Brand Names Associated with Nilotinib

  • Nilotinib
  • Tasigna®

Brand Names Associated with Cilostazol

  • Cilostazol
  • Pletal®

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Last updated Dec 19, 2023


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Interaction Effect

Increased cilostazol exposure


Interaction Summary

Cilostazol exposure is increased with concomitant administration of strong or moderate CYP3A4 inhibitors. The AUC of cilostazol was increased by 117% with concomitant administration of ketoconazole. When coadministration is required, consider reducing the cilostazol dose to 50 mg twice daily.


Severity

Major


Onset

Unspecified


Evidence

Theoretical


How To Manage Interaction

Cilostazol exposure is increased with concomitant administration of strong or moderate CYP3A4 inhibitors. Consider reducing the cilostazol dose to 50 mg twice daily if coadministration is required.


Mechanism Of Interaction

Inhibition of CYP3A4-mediated metabolism of cilostazol


Literature Reports

A) Coadministration of ketoconazole 400 mg and cilostazol 100 mg increased cilostazol AUC by 117% and Cmax by 94% .

B) Coadministration of erythromycin and cilostazol increased cilostazol AUC by 72% and Cmax by 47%, and increased the AUC of the 4`-trans-hydroxy-cilostazol metabolite by 141% .

C) Coadministration of diltiazem and cilostazol increased cilostazol AUC by roughly 40% and Cmax by roughly 30%, and decreased the clearance of cilostazol by roughly 30% .

Nilotinib Overview

  • Nilotinib is used to treat certain types of chronic myeloid leukemia (CML; a type of cancer of the white blood cells) who have recently found to have this condition in adults and children 1 year of age and older. It is also used to treat certain types of CML in adults whose disease could not be treated successfully with imatinib (Gleevec) or adults who cannot take imatinib because of side effects. Nilotinib is also used to treat certain types of CML in children 1 year of age or older whose disease could not be treated successfully with other tyrosine kinase inhibitor therapies or who cannot take these medications because of side effects. Nilotinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps to stop or slow the spread of cancer cells.

See More information Regarding Nilotinib

Cilostazol Overview

  • Cilostazol is used to reduce the symptoms of intermittent claudication (pain in the legs that worsens when walking and improves when resting that is caused by narrowing of the blood vessels that supply blood to the legs). Cilostazol is in a class of medications called platelet-aggregation inhibitors (antiplatelet medications). It works by improving blood flow to the legs.

See More information Regarding Cilostazol

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.


Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.


Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.


How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.


Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.


Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.