Anticoagulant / Antiplatelet Stoppage For Procedures
generic (Brand)
Dept.
Procedure Type (hover over entry for examples)
Stop Medication Prior To Procedure Restart after:
cilostazol (Pletal)
Anesthesia
High-risk
48 hours Restart after 24 hours
Intermediate-risk
No hold Restart after 24 hours
Low-risk
No hold Restart after 24 hours
Patients with high risk of bleeding (eg, old age, history of bleeding tendency, concurrent uses of other anticoagulants/antiplatelets, liver cirrhosis or advanced liver disease, and advanced renal disease) undergoing low- or intermediate-risk procedures should be treated as intermediate or high risk, respectively.
Radiology
Invasive Procedures
3 days
Paracentesis/Thoracentesis
No hold
Surgery
High-risk
7 days Restart after 24 hours
Low-risk
No Hold Restart after 24 hours
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication:
cilostazol (Pletal)
Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3)
Drug(s) ⇆ disease or syndrome
cilostazol ⇄ Heart failure
Rationale
Potential to increase mortality in older adults with heart failure
Recommendation
Avoid
Quality of evidence: Low, Strength of Recommendation: Strong
(hover over entry for examples)
(Pletal)