Side Effects of Pletaal in Cardiovascular Patients - Cardiology

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Side effects of Pletaal (cilostazol)?


Hello, my father is a dialysis patient and was recently diagnosed with severe narrowing of the calf arteries.
The doctor prescribed Pletaal (cilostazol) 100 mg, to be taken once in the morning and once in the evening, and Lipitor (atorvastatin) half a tablet once a day.
After taking the medications for two days, my father's heart rate has noticeably increased to between 80-100 beats per minute, while he usually has a heart rate of 50-60.
I would like to ask the doctor if the increased heart rate is related to these two medications.
He has a history of arrhythmia, but it has been a long time since he experienced such a rapid heart rate.
I am unsure of what to do.
Thank you for your assistance!

amy, 30~39 year old female. Ask Date: 2024/06/07

Dr. Huang Yinghe reply Cardiology


Hello, Pletaal is an antiplatelet medication used to promote blood circulation, while Lipitor is a cholesterol-lowering drug.
Pharmacologically, neither of these medications directly causes an increased heart rate.
Many other conditions can lead to an increased heart rate, such as allergies, gastrointestinal bleeding induced by antiplatelet medications, infections, or other diseases.
It is advisable for your father to return for a follow-up appointment so that a physician can evaluate him to determine the cause.

Reply Date: 2024/06/07

More Info


Pletaal (cilostazol) is a medication commonly used to treat intermittent claudication in patients with peripheral arterial disease (PAD). It works by inhibiting platelet aggregation and causing vasodilation, which can improve blood flow to the extremities. Lipitor (atorvastatin) is a statin used to lower cholesterol levels and reduce the risk of cardiovascular events. While both medications are beneficial for cardiovascular health, they can also have side effects that may affect patients differently, especially those with underlying conditions such as kidney disease.

In your father's case, the increase in heart rate from a baseline of 50-60 beats per minute to 80-100 beats per minute after starting Pletaal and Lipitor raises some important considerations. Cilostazol can cause side effects, including palpitations and tachycardia (increased heart rate). This effect may be more pronounced in patients with pre-existing heart rhythm issues, such as your father's history of arrhythmia. It is essential to monitor these changes closely, especially since he has a history of irregular heartbeats.

The increase in heart rate could be attributed to several factors:
1. Medication Side Effects: Cilostazol can lead to increased heart rate as a side effect. If your father has not experienced such a heart rate previously, it is important to consider whether the introduction of this medication is the cause.

2. Underlying Conditions: Given that your father is a dialysis patient, his cardiovascular system may be more sensitive to changes in medication. Kidney disease can affect how medications are metabolized and eliminated from the body, potentially leading to increased side effects.

3. Electrolyte Imbalances: Patients on dialysis often experience fluctuations in electrolytes, which can contribute to changes in heart rhythm and rate. It is crucial to ensure that his electrolyte levels are within normal ranges, as imbalances can exacerbate arrhythmias.

4. Stress and Anxiety: Starting new medications can sometimes lead to anxiety, which may also contribute to an increased heart rate. Psychological factors should not be overlooked in the assessment of heart rate changes.

Given these considerations, it is advisable to take the following steps:
- Consult the Prescribing Physician: It is crucial to discuss these symptoms with your father's healthcare provider as soon as possible. They may want to evaluate whether the medications should be adjusted or if further investigations are necessary.

- Monitor Heart Rate: Keep a record of your father's heart rate at different times of the day, noting any associated symptoms such as dizziness, chest pain, or shortness of breath. This information can be valuable for the healthcare provider.

- Evaluate Kidney Function: Since your father is on dialysis, regular monitoring of kidney function and electrolyte levels is essential. Any abnormalities may need to be addressed to prevent complications.

- Consider Alternative Treatments: If cilostazol is determined to be the cause of the increased heart rate, the physician may consider alternative treatments for managing your father's peripheral artery disease that may have a more favorable side effect profile.

In conclusion, while Pletaal and Lipitor are effective medications for managing cardiovascular conditions, they can have side effects that may be particularly relevant in patients with complex medical histories, such as those undergoing dialysis. Close communication with healthcare providers is essential to ensure that any adverse effects are managed appropriately and that your father's treatment plan is optimized for his specific needs.

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