Dilvas

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Dilvas

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Dilvas

Dilvas is a prescription-only synthetic medication used in the management of circulatory issues. Its active ingredient is Cilostazol.

Property Description
Active ingredient Cilostazol (C20H27N5O2)
Form Oral tablet
Pharmacological class Selective Phosphodiesterase III (PDE3) Inhibitor
Common purpose To improve blood circulation
Origin Synthetic compound

What Type of Medicine is Dilvas (Cilostazol)?

Dilvas is classified pharmacologically as a Selective Phosphodiesterase III (PDE3) Inhibitor. This mechanism places the drug within the broader group of Platelet Aggregation Inhibitors, reflecting its capacity to prevent cell clumping in the blood. The medication is a synthetic compound manufactured for systemic delivery, relying solely on the efficacy of its single active ingredient, Cilostazol.

Composition and Physical Form of Dilvas

The therapeutic substance in Dilvas is exclusively Cilostazol, which is provided to the patient as a standardized oral tablet. This solid dosage form is designed for systemic absorption following ingestion, establishing the oral route as the designated method of administration. The tablet composition includes the therapeutic compound alongside standard solid pharmaceutical excipients necessary for stability and manufacturing.

What is the General Purpose of Cilostazol?

Cilostazol's general purpose is to facilitate improved blood circulation and tissue perfusion. Its pharmacological action is dual: it promotes vasodilation (widening of blood vessels) while simultaneously providing an antiplatelet effect. This combined physiological action fundamentally enhances blood flow, particularly in the limbs, mitigating the challenges associated with restricted peripheral circulation.

What side effects are possible with Dilvas?

Possible Side Effects and Safety Information

The official safety profile for Dilvas (Cilostazol) details adverse reactions across several major physiological systems, categorized by frequency as defined in regulatory documents.

Frequency-Classified Adverse Reactions

The most frequently documented effects include those classified as Very Common (ge 1/10), such as Headache, Diarrhea, and Abnormal Stools. Effects classified as Common (ge 1/100 to < 1/10) include reactions across the Nervous System (Dizziness), Gastrointestinal System (Nausea, Vomiting, Dyspepsia), and Cardiac System (Palpitations, Tachycardia, Angina pectoris).

Serious Adverse Reactions and Safety Constraints

Official labeling documents highlight the potential for Serious Adverse Reactions, which, though uncommon, include Myocardial Infarction, Stroke, Congestive Heart Failure, and serious Bleeding Events (e.g., Intracranial Hemorrhage). Additionally, hematological disorders such as Agranulocytosis and Severe Thrombocytopenia are cited.

Use of Cilostazol is subject to specific regulatory constraints. The medicine is contraindicated in patients with Congestive Heart Failure of any severity, a known bleeding tendency (e.g., active ulcers), or specific severe cardiac conditions. Use is also restricted when co-administered with two or more additional antiplatelet or anticoagulant agents due to an increased potential for bleeding risk. Caution is advised in patients with severe renal or hepatic impairment.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory documentation states that the signs and symptoms of Dilvas (Cilostazol) overdose are consistent with an excessive pharmacological effect.

Documented Overdose Manifestations
Cardiovascular Effects: Severe tachycardia (fast heart rate), palpitations, tachyarrhythmia, and a significant drop in blood pressure (hypotension).
Systemic Effects: Severe headache, dizziness, fainting, and severe diarrhea.

Emergency Actions and Management
Immediate Help Required: Seek immediate medical attention or call emergency services if a suspected overdose has occurred. Immediate help is mandated if the person has collapsed, had a seizure, has trouble breathing, or cannot be awakened.
Severe Outcomes: Overdose carries the potential for life-threatening events, including major gastrointestinal hemorrhage, intracranial hemorrhage, and serious cardiac arrhythmias, particularly in individuals with pre-existing heart disorders.
Management: Treatment is symptomatic and supportive, as no specific antidote is known. Measures such as gastric lavage or activated charcoal may be considered by healthcare providers to reduce drug absorption, and close observation of cardiovascular status is required.

The regulatory profile highlights the need for urgent professional assessment due to the potential for severe cardiovascular and bleeding complications. These documented manifestations and the lack of a specific antidote dictate that the mandated regulatory action is to seek immediate medical attention for all suspected overdose scenarios.

Therapeutic Uses of Dilvas

Main Uses of Dilvas

Dilvas is a medication containing the active ingredient enalapril, which belongs to a class of drugs known as angiotensin-converting enzyme (ACE) inhibitors. It is primarily utilized in the management of cardiovascular conditions where the regulation of blood pressure and heart function is necessary.

Management of Hypertension

The primary use of Dilvas is the treatment of high blood pressure (hypertension). It works by relaxing and widening the blood vessels, which allows blood to flow more easily throughout the body. Effective management of blood pressure is a key factor in reducing the long-term strain on the cardiovascular system.

Heart Failure Treatment

Dilvas is indicated for the treatment of symptomatic heart failure. In this condition, the heart muscle is unable to pump blood as effectively as it should. By reducing the workload on the heart and improving blood flow, the medication helps manage the clinical symptoms associated with this condition.

Prevention of Heart Failure Development

In addition to treating active symptoms, Dilvas is used in patients with asymptomatic left ventricular dysfunction. This refers to a condition where the heart's main pumping chamber is weakened, but the patient has not yet developed outward signs of heart failure. The medication is used in these cases to help delay or prevent the progression to symptomatic heart failure.

Benefits of Treatment

Cardiovascular Protection

By maintaining blood pressure within a target range, Dilvas helps protect vital organs from the damage that chronic hypertension can cause. This includes lowering the risk of complications such as strokes and myocardial infarction (heart attack).

Improved Clinical Outcomes

For patients with heart failure or ventricular dysfunction, the use of Dilvas is associated with a reduction in the frequency of hospitalizations. It plays a role in stabilizing heart function and improving the overall prognosis for individuals with chronic cardiac conditions.

Eligibility and Restrictions for Use

Eligibility for Dilvas: Official Regulatory Information

Dilvas is contraindicated and must not be used in patients with a known hypersensitivity to the active substance or any other component of the medicine, as documented in official regulatory labeling.

The medicine is also contraindicated in all patients who have active liver disease, including those with unexplained, persistent elevations in liver enzyme levels (hepatic transaminases).

Contraindicated Populations Special Consideration Required
Known hypersensitivity to the drug or any component. Patients aged 65 years and older (increased risk of muscle effects).
Active liver disease (including unexplained persistent liver enzyme elevations). Patients with renal impairment (kidney function problems).
Women who are pregnant or who may become pregnant. Temporary discontinuation may be required during acute, serious conditions (e.g., major surgery, severe infection).
Women who are breastfeeding (lactating).
Concomitant use with Cyclosporine.

Use is not recommended or requires special caution in patients with predisposing factors for myopathy (muscle disease), such as advanced age, hypothyroidism that is not adequately controlled, or existing renal impairment. Pediatric use in children under eight years of age is not established, according to governmental safety documents.

What should I know about interactions with other medicines?

Pharmacokinetic and Contraindicated Combinations

Dilvas (Cilostazol) exhibits clinically significant pharmacokinetic (PK) interference, primarily through the inhibition of its major metabolizing enzymes, CYP3A4 and CYP2C19. Co-administration with strong CYP3A4 inhibitors, such as Ketoconazole, or moderate inhibitors like Erythromycin and Diltiazem, causes a documented increase in the systemic exposure (AUC and Cmax) of Cilostazol. The CYP2C19 inhibitor Omeprazole similarly increases the exposure of an active metabolite. Due to this elevated exposure, the European regulatory profile explicitly contraindicates the combination of Cilostazol with strong inhibitors of either CYP3A4 or CYP2C19.


Pharmacodynamic Augmentation and Regulatory Restrictions

A critical restriction is driven by pharmacodynamic (PD) augmentation. Cilostazol's antiplatelet action creates a heightened risk of bleeding when combined with other antiplatelet agents (e.g., Aspirin) or anticoagulants (e.g., Warfarin). Regulatory agencies restrict the use of Cilostazol with two or more additional antiplatelet or anticoagulant medicines. Furthermore, its classification as a PDE3 inhibitor dictates that use is contraindicated in patients with Heart Failure of any severity.


Dietary Interactions and Timing Rules

The official profile includes restrictions based on diet. To manage the effect of high-fat meals on Cilostazol absorption, the official label includes a timing-based administration rule advising separation: the medicine must be taken at least one-half hour before or two hours after food. Substances that inhibit CYP3A4, such as Grapefruit Juice, are documented to increase plasma concentration and must be avoided.

Mechanism of Action

How Dilvas Works

Targeted Receptor and Enzyme Modulation

Dilvas initiates its action by selectively engaging specific [receptor or enzyme] systems located within key regulatory pathways. This direct interaction functions to modulate the activity of these biological targets, either by blocking their function (antagonist) or altering their responsiveness. This core mechanism establishes a change in pathway activity by modulating or altering upstream signaling.

Regulating Signaling Dynamics and Pathways

The drug is applied to systems characterized by overactive or dysregulated physiological processes driven by specific mediators. Dilvas operates within these pathways to influence signaling dynamics toward a less excessive rate, modulating information flow between cells. This action is relevant when a targeted adjustment within central or peripheral mechanistic domains is necessary for the adjustment of activity within these domains.

Limiting Downstream Cascades and Physiological Impact

By controlling the initial molecular steps, Dilvas modifies subsequent molecular cascades, effectively limiting the proliferation and impact of overactive mediators. This systematic dampening of the signaling sequence leads to a change in the state of physiological responses and results in a modulation of activity within the targeted pathways. The resulting physiological adjustments are the direct consequence of this comprehensive mechanistic interference.

Dosage and Administration Information

Administration Guidelines for Dilvas

The following instructions detail the proper use of Dilvas. All administration rules are provided as descriptive information regarding the use of the medication and do not include therapeutic benefits, safety information, or clinical advice.

Dilvas is administered orally and is available as film-coated tablets in various strengths, or as a liquid oral suspension that must be prepared by a pharmacist.

Dosage and Timing

The medicine may be taken with or without food. For most conditions, administration occurs once daily or twice daily (BID), depending on the specific regimen. Doses are typically started low and gradually increased (uptitrated) over a period of 2 to 4 weeks to reach the target maintenance dose, as tolerated. For example, in adult hypertension, the starting dose is 80 mg or 160 mg once daily, with a maximum daily dose of 320 mg.

Patient Population Recommended Starting Dose
Adult Hypertension 80 mg or 160 mg once daily
Adult Heart Failure 40 mg twice daily
Pediatric (6-16 yrs) 1.3 mg/kg once daily (max 40 mg)

Preparation and Handling

The liquid oral suspension form requires specific preparation steps: the pharmacist must mix the tablets with designated vehicles (Ora-Plus and Ora-Sweet SF), including mandatory shaking for 2 minutes and letting the mixture stand for at least one hour before final dispensing. The oral tablet and the liquid suspension are not equivalent and cannot be substituted on a milligram-per-milligram basis. No dosage adjustment is required for elderly patients or those with mild to moderate renal or hepatic impairment.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Dilvas

Evidence for Use in Intermittent Claudication

Dilvas (Cilostazol) was studied for people with Intermittent Claudication, a condition marked by functional limitations that arise during walking. The research examined the functional axes related to physical discomfort. The primary evidence was derived from many short-term to intermediate-term Randomized Controlled Trials (RCTs). These studies monitored outcomes reflecting daily functioning or activity level, such as Pain-Free Walking Distance and Maximal Walking Distance on a standardized treadmill test. This research focused mainly on adults with stable, moderate-to-severe symptoms of Peripheral Arterial Disease (PAD).

Research highlights changes measured in walking distance during the study period, with patterns described typically over the first few months of observation. Studies reported measurements of walking distance in the groups receiving the compound. Researchers also examined if there were any changes in certain biomarkers, such as cholesterol and triglyceride levels. However, follow-up durations were limited for the main functional outcomes like walking distance. Research provides insight into short-term changes, but there is insufficient data for long-term outcomes regarding the durability of change in walking ability.

Evidence for Use After Arterial Procedures (Post-Revascularization)

Dilvas was studied for use in patients who had undergone procedures—such as angioplasty or other interventions—to restore blood flow in their peripheral arteries. This research examined outcomes related to the treated vessels remaining open, which is called patency. The studies monitored outcomes related to the need for repeat procedures over time. What remains uncertain is the widespread applicability of these findings, as results apply only to the populations studied and the data for certain groups remain insufficient.

What Is Still Uncertain About the Research for Dilvas

Certainty remains low regarding how the measured changes in walking distance relate to serious vascular events, such as the risk of requiring an amputation, or experiencing a heart attack or stroke. The existing efficacy studies focused on different endpoints. Overall, while the research helps contextualize how patients reported their experience of symptoms over the short term, the evidence landscape presents gaps: comparative evidence is lacking for some of the procedural outcomes, and there is limited information for long-term outcomes for functional ability.

Key Studies & References

  1. Systematic review and meta-analysis of randomized clinical trials appraising the impact of cilostazol after percutaneous coronary intervention

Frequently Asked Questions (FAQ)

Common questions about Dilvas (FAQ)

Q: What is the main medical condition Dilvas is approved to treat?

Official product information indicates that this medicine is approved for the treatment of intermittent claudication, a condition causing leg pain or cramping during exercise. This condition is related to poor circulation, specifically peripheral vascular disease. The medicine is intended to help manage symptoms associated with this chronic condition, according to regulatory information.


Q: How does the drug Dilvas work inside the body (in plain language)?

According to official sources, the medicine works in two primary ways to influence blood flow to the limbs. It helps to relax and widen blood vessels (vasodilation) and also reduces the ability of certain blood cells (platelets) to stick together. This combined action works to promote improved blood circulation, based on the established mechanism.


Q: What is the typical timeframe before Dilvas's effects are generally noticed?

Studies suggest that patient reports indicate symptoms may begin to improve within two to four weeks of beginning the medicine. However, official therapeutic documents indicate that it may take up to 12 weeks of consistent use to achieve the full or optimal clinical effect.


Q: Are there common lifestyle changes mentioned when starting Dilvas?

Regulatory documents note that smoking decreases the exposure of the medicine in the body, which may reduce its effectiveness. Official documentation reminds patients that all lifestyle factors, particularly those affecting circulation, should be reviewed with a healthcare provider.


Q: Is Dilvas a drug that is commonly prescribed for people under the age of 18?

Regulatory information indicates the safety and effectiveness of the medicine have not been established in children. This includes individuals under the age of 18, meaning its use in this age group is not supported by official data.


Q: Can Dilvas affect a person's ability to drive or operate machinery?

The official product information lists dizziness and drowsiness as possible side effects. Official warnings caution against driving or operating heavy machinery until the individual is certain how the medicine affects their alertness.


Q: Are there any documented cases of allergic reactions to Dilvas?

Official labeling highlights the possibility of severe allergic reactions. Symptoms can include difficulty breathing, swelling of the face, lips, or throat, and skin reactions like hives. These symptoms warrant immediate medical evaluation.


Q: Do older adults typically need special monitoring when prescribed Dilvas?

Studies have not shown specific age-related problems that would limit the drug's use in older adults (e.g., ages 50 to 80). However, the potential for blood disorders means monitoring of blood parameters is advised for all patients, regardless of age.


Q: Does Dilvas interact with common blood pressure medications?

Official warnings address the possibility of blood pressure falling too low when this medicine is combined with other agents that lower blood pressure. Patients should ensure their healthcare provider has a complete list of all concurrent medications.


Q: Are there any known long-term side effects that have been studied for Dilvas?

While many adverse reactions occur early in treatment, reports indicate that a small number of reactions have been documented after long-term use (exceeding one year). The potential for adverse reactions reported over long periods is a subject of ongoing safety monitoring.


Q: Can Dilvas be taken at the same time as cold and flu medicine?

The risk of bleeding may be increased when this medicine is taken with common pain relievers that have antiplatelet effects, such as nonsteroidal anti-inflammatory drugs (NSAIDs) often found in cold and flu remedies. Patients should review the active ingredients of any concurrent treatment with a healthcare provider.


Q: Is Dilvas known to cause changes in sleep patterns?

The side effect of drowsiness, listed in the official safety data, is a factor that may affect sleep-wake cycles. Patients should report any changes in alertness or persistent daytime sleepiness.


Q: Does Dilvas have any known potential interactions with herbal supplements?

Official documentation emphasizes the need for a healthcare provider to review all herbal products and supplements being used concurrently. This is due to the potential for interactions that could alter how the medicine works in the body.


Q: Why do some people need to take Dilvas for a long time?

The medicine is prescribed for the relief of symptoms related to a chronic condition, such as intermittent claudication. Because the condition is chronic, the therapeutic effect must be maintained over time.


Q: What is the difference between Dilvas and other similar medications in its class?

The medicine is categorized as a Phosphodiesterase Type III (PDE3) inhibitor, reflecting its specific mechanism of action. This is distinct from other common antiplatelet agents like Aspirin or Clopidogrel, which work through different pathways.


Q: Is Dilvas considered a medication that could be habit-forming?

Official labeling and product information report that this medicine is not considered to carry a risk of being habit-forming or of dependence.


Q: What happens if a patient misses taking a dose of Dilvas?

The regulatory instruction is that if a dose is missed, the next dose should be taken at the regularly scheduled time. A double or extra dose must not be taken to make up for the missed one.


Q: Are there any specific laboratory tests that need to be performed while taking Dilvas?

Monitoring of blood parameters is necessary due to the potential for certain blood disorders, such as low platelet or white blood cell levels. Patients are encouraged to follow the schedule for any blood checks requested by their healthcare team.


Q: How long after stopping Dilvas does the substance generally clear from the system?

Pharmacokinetic data from official documents indicate that the medicine and its active breakdown products have an apparent elimination half-life of approximately 11 to 13 hours. The body generally clears the majority of the substance over the course of several half-lives.


Q: Is the active ingredient in Dilvas available under a different name?

Yes, the active ingredient in this medicine, Cilostazol, is available under other brand names. One well-known alternative brand name listed in regulatory documents is Pletal.


Q: What is the significance of the tablet strength for Dilvas?

The medicine is generally available in two main tablet strengths: 50 mg and 100 mg. Different strengths are available to allow for flexible use, particularly when drug concentrations may be affected by other concurrent medications.


Q: Can Dilvas cause any changes in weight?

Official safety information lists 'loss of appetite' as a possible side effect. Additionally, changes in weight, especially sudden weight gain, warrant immediate medical evaluation as they may be signs of potential heart issues.


Q: Does alcohol consumption present a risk while on a course of Dilvas?

Official warnings suggest that consuming alcohol with this medicine carries a risk. The combination may potentially increase the risk of stomach bleeding.


Q: Can Dilvas be crushed or split if a patient has difficulty swallowing pills?

The regulatory instruction is that the tablet must be swallowed whole and must not be crushed, chewed, or broken. This instruction helps ensure the medicine works as intended.


Q: What is the half-life of Dilvas as described in official documents?

Pharmacokinetic data from official documents indicate that the medicine and its active breakdown products have an apparent elimination half-life of approximately 11 to 13 hours. The half-life is a measure of how quickly the body processes and removes the substance.


Q: Why is it important to complete the full course of Dilvas even if symptoms improve?

Official guidance emphasizes taking the medicine exactly as prescribed, even if symptoms begin to improve quickly. This ensures the necessary time has been allotted to fully establish the clinical benefit.

How should Dilvas be stored and disposed of?

Official Storage and Disposal Requirements

Dilvas (Cilostazol) must be stored strictly according to the conditions outlined in official regulatory labeling.

Requirement Type Official Regulatory Statement
Storage Temperature Store at Controlled Room Temperature, defined as 20 C to 25 C (68 F to 77 F), with permitted excursions to 30 C [1.1].
Protection/Handling Keep the medicine out of the reach of children and pets [3.4]. Store away from heat, moisture, and direct light. Keep from freezing [3.4].
Container Rules Preserve in the original container, tightly closed [2.4, 3.4].
Disposal Dispose of unused or expired tablets via a drug take-back program or by following the official household trash method (mixing with an unpalatable substance and sealing) [2.6]. Do not flush the tablets down the sink or toilet [2.3].

Regulatory documents specify that the container must be sealed and stored under controlled conditions to maintain the product's quality over its shelf-life [1.5]. Disposal must follow a controlled process, preventing environmental release and accidental exposure [2.8].

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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