Drug & supplement interaction

Fasting + Cilostazol

Cilostazol brand name: Pletal.

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

Fasting has a moderate interaction with Cilostazol. Fasting may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Fasting and Cilostazol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Cilostazol

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

Fasting may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Fasting has been found to increase the international normalized ratio (INR) in patients stabilized on warfarin. Closely monitor patients who are fasting while taking anticoagulant or antiplatelet drugs. Dose adjustment may be necessary.
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 gist with cilostazol (Pletal): it's an antiplatelet medicine, so it already makes your blood a little slower to clot to help blood move through your legs. The note on file suggests that going through periods of fasting might add to that blood-thinning effect, nudging up your risk of bruising or bleeding. I want to be straight with you, though, this is based on weak, anecdotal reports (much of it tied to warfarin, not cilostazol specifically), so it's far from a sure thing.

What to watch for would be easy bruising, nosebleeds, or bleeding gums. Don't change your fasting routine or your dose on your own. If you're planning to fast regularly, give your pharmacist or doctor a heads-up so they can keep an eye on you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wilhelmi de Toledo F, Grundler F, Bergouignan A, Drinda S, Michalsen A. Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects. PLoS One. 2019;14(1):e0209353. PubMed
  2. Katada Y, Nakagawa S, Nishimura A, et al. Effects of fasting on warfarin sensitivity index in patients undergoing cardiovascular surgery. Eur J Clin Pharmacol. 2019;75(4):561-568. PubMed
  3. Lai YF, Cheen MHH, Lim SH, et al. The effects of fasting in Muslim patients taking warfarin. J Thromb Haemost. 2014;12(3):349-54. 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

Fasting Also Interacts With Other Medications

Fasting has 2 major, 205 moderate known drug interactions in our database — the Cilostazol one above is one of them. If you take anything else, check it against the full list below.

Major 2 Moderate 205 No known interaction 2,623 (incl. Cilostazol)
Taking anything else?

Check Another of Your Medications Against Fasting

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

From our Q&A

Questions About Fasting 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 Fasting 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 Fasting 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

How much people look this up

Where Fasting 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 Fasting
Top half

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

29 days ago today
Medication Cilostazol
Steady interest

#1,779 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.

Eating pattern

About Fasting

What is Fasting?

  • Weight loss
  • Blood sugar control
  • Heart health
  • Religious or spiritual practice
  • General wellness and longevity

Fasting means voluntarily going without food (and sometimes drink) for set periods. Some research suggests it may help with weight loss and blood sugar in certain people, but results vary and quality of evidence is mixed. It is not safe for everyone, so check with your doctor or pharmacist before starting—especially if you take medication or have a health condition.

Read the full Fasting monograph & all interactions
Medication

About Cilostazol

What Is Cilostazol Used For?

Brand name: Pletal

Cilostazol tablets are approved to reduce the symptoms of intermittent claudication (cramping leg pain that comes on during walking due to reduced blood flow in the arteries). The goal is to help you walk farther before pain forces you to stop.

See full Cilostazol drug information
Keep checking

Other Drugs & Fasting

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

2Major
205Moderate
0Minor
2,622No known interaction
2 Major 205 Moderate 2,622 No interaction
Major

2 interactions

Moderate

205 interactions

Showing 60 of 205 moderate interactions — see all 205 on the Fasting page.

No interaction 2,622 drugs checked — show the list

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

Showing the 60 most looked-up of 2,622 medications checked with no known interaction — see the full Fasting list.

See the full Fasting 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
Fasting 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

Following Fasting While Taking Cilostazol: Common Questions

Can you follow Fasting while taking 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.
How serious is the Fasting 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 Fasting?

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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.