Drug & supplement interaction

Atractylodes + Cilostazol

Cilostazol brand name: Pletal.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Cilostazol falls into 2 drug categories that Atractylodes can interact with; the most serious is rated moderate. Theoretically, atractylodes might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Atractylodes and Cilostazol

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Atractylodes interacts with whole categories of medication. Cilostazol falls into 2 of those categories, so it can interact with Atractylodes in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Cilostazol

Cilostazol falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Atractylodes interacts with.

Theoretically, atractylodes might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.
Laboratory research suggests that atractylenolides II and III, constituents of atractylodes, reduce platelet activation. So far, this has not been shown in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: Cilostazol (Pletal) already works to keep your platelets from clumping and to help blood flow more easily through your legs. Lab studies hint that certain compounds in atractylodes (atractylenolides II and III) may also make platelets a bit less sticky. Stack the two together and, in theory, you could lean further toward easy bruising, nosebleeds, bleeding gums, or cuts that take longer to stop.

I want to be honest about the strength of this, though. This is only seen in test tubes and animals, not in people, so it's a possible concern rather than a proven one. Don't stop or change anything on your own. Just give your pharmacist or doctor a heads-up before adding atractylodes, and watch for any unusual bruising or bleeding.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chen Y, Yang W, Guo L, Wu X, Zhang T, Liu J, Zhang J. Atractylodes lactone compounds inhibit platelet activation. Platelets. 2017 Mar;28(2):194-202. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Cilostazol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, atractylodes might increase the levels of CYP3A4 substrates.
In animals, atractylodes administered at high doses has been shown to inhibit CYP3A1 activity, which is a homolog to the human CYP3A4 enzyme. This effect has not been shown in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the basic idea with cilostazol (Pletal). Your body clears this drug largely through a liver enzyme called CYP3A4. Atractylodes, at least in lab and animal tests, may slow that enzyme down a bit. If it does, cilostazol could hang around longer and its effects could feel stronger than usual. With cilostazol that might mean more headache, dizziness, a fast or pounding heartbeat, loose stools, or easier bruising.

That said, I want to keep this in perspective. This is a theoretical, minor concern based on animal studies, not something proven in people, so for most folks it's likely small. Still, since cilostazol affects blood flow and bleeding, it's worth a quick chat with your pharmacist or doctor before adding atractylodes.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Muhamad N, Plengsuriyakarn T, Na-Bangchang K. Atractylodes lancea for cholangiocarcinoma: Modulatory effects on CYP1A2 and CYP3A1 and pharmacokinetics in rats and biodistribution in mice. PLoS One 2022;17(11):e0277614. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Atractylodes Also Interacts With Other Medications

Atractylodes has 126 moderate, 674 minor known drug interactions in our database — the Cilostazol one above is among them. If you take anything else, check it against the full list below.

Moderate 126 Minor 674 No known interaction 2,030 (incl. Cilostazol)
Taking anything else?

Check Another of Your Medications Against Atractylodes

Covers the 2,830 medications we’ve checked against Atractylodes. Pick one to open its full report.

From our Q&A

Questions About Atractylodes or Cilostazol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Atractylodes or Cilostazol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Cilostazol

This page covers Atractylodes only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cilostazol page lists 286 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 41 minor.

Open the Cilostazol interaction page

One more smart check

Taking Atractylodes as Part of a Dietary Supplement Product? Check It for Interactions

We hold 691 real supplement products containing Atractylodes, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Atractylodes. Your product may carry other ingredients that interact with Cilostazol too, on top of Atractylodes — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Atractylodes and Cilostazol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Atractylodes
Top 25%

#215 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Cilostazol
Steady interest

#1,525 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Atractylodes

What is Atractylodes?

Atractylodes
  • Digestive upset and poor appetite
  • Bloating and fluid retention
  • General fatigue or 'weakness'
  • Diarrhea
  • Support within traditional formulas

Atractylodes is a root used for centuries in traditional Chinese, Japanese, and Thai medicine, mostly for digestive complaints and fatigue, often as part of multi-herb formulas. Modern research is still early and mostly from lab and animal studies, so its true benefits in people are not well proven. If you want to try it, talk with a pharmacist or doctor first, and avoid it during pregnancy and breastfeeding.

Read the full Atractylodes monograph & all interactions
Medication

About Cilostazol

What Is Cilostazol Used For?

Brand name: Pletal

Cilostazol tablets are used to reduce the symptoms of intermittent claudication. This is leg pain or cramping that shows up when you walk and eases with rest.

The goal is to help you walk a longer distance before symptoms start.

See full Cilostazol drug information
Keep checking

Other Drugs & Atractylodes

Browse every other medication we’ve checked against Atractylodes — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
126Moderate
674Minor
2,029No known interaction
126 Moderate 674 Minor 2,029 No interaction
Moderate

126 interactions

Showing 60 of 126 moderate interactions — see all 126 on the Atractylodes page.

Minor

674 interactions

Showing 60 of 674 minor interactions — see all 674 on the Atractylodes page.

No interaction 2,029 drugs checked — show the list

We also checked Atractylodes against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,029 medications checked with no known interaction — see the full Atractylodes list.

See the full Atractylodes interactions page
See every supplement checked against Cilostazol, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Atractylodes monograph › Uses, safety, and every drug interaction in one place Cilostazol supplement interactions › Every supplement checked against Cilostazol, ranked by severity Cilostazol drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Atractylodes and Cilostazol Together: Common Questions

Can you take Atractylodes with Cilostazol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Atractylodes and Cilostazol?
Cilostazol belongs to more than one drug category, and Atractylodes interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Atractylodes and Cilostazol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Cilostazol and Atractylodes?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.