Iloprost

Iloprost is a prescription medication used to treat the symptoms of Pulmonary Arterial Hypertension. Iloprost is also a prescription medication used to treat severe frostbite in adults to reduce the risk of digit amputation.

• Iloprost is available under the following different brand names: Aurlumyn and Ventavis.

Aurlumyn

Adult dosage

Injectable solution

• 100 mcg/mL single-dose vial

Frostbite

Adult dosage

• Administer as continuous IV over 6 hours each day for up to a maximum of 8 consecutive days
• Dose based on actual body weight
• Days 1-3
  • 0.5 ng/kg/min IV initially
  • Increase by 0.5 ng/kg/min every 30 mins according to tolerability
  • Not to exceed 2 ng/kg/min
  • Repeat dose titration steps on day 2 and day 3
• Day 4 and thereafter
  • Start infusion at the highest tolerated dose from the previous day
  • Adjust rate as needed, based on tolerability

Ventavis

Adult dosage

Single-use ampule

• 10mcg/mL (1mL)
• 20mcg/mL (1mL)

Pulmonary Arterial Hypertension

Adult dosage

• Initial: 2.5 mcg inhaled, if well-tolerated, THEN
• 5 mcg subsequent doses
• 6-9 times/day as needed; every 2 hours while awake
• Maintenance: 2.5-5 mcg/dose; not to exceed 45 mcg/day

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Iloprost (Aurlumyn) include:

• headache
• flushing
• palpitations/fast heart rate
• nausea
• vomiting
• dizziness
• low blood pressure (hypotension)

Serious side effects of Iloprost (Aurlumyn) include:

• hypotension

Rare side effects of Iloprost (Aurlumyn) include:

• none 

Common side effects of Iloprost (Ventavis) include:

• pneumonia,
• increased cough,
• coughing up blood,
• pounding heartbeats,
• low blood pressure,
• light-headedness,
• flu symptoms,
• flushing (warmth, redness, or tingly feeling),
• headache,
• abnormal liver function tests,
• nausea,
• vomiting,
• muscle cramps,
• back pain,
• tongue pain,
• jaw tightness or pain,
• trouble chewing or speaking, and
• sleep problems (insomnia)

Serious side effects of Iloprost (Ventavis) include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• pounding heartbeats,
• fluttering in the chest,
• pain or tightness in the jaw,
• unusual bleeding (nosebleeds, bleeding gums),
• fever,
• chills,
• cough with mucus,
• chest pain,
• shortness of breath,
• pain when you breathe,
• shortness of breath while lying down,
• wheezing,
• gasping for breath,
• cough with foamy mucus,
• cold and clammy skin,
• anxiety, and
• rapid heartbeats

Rare side effects of Iloprost (Ventavis) include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Iloprost has severe interactions with no other drugs
• Iloprost has serious interactions with no other drugs
• Iloprost has moderate interactions with at least 92 other drugs
• Iloprost has minor interactions with no other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• None well documented

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Iloprost?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Iloprost?”

Cautions

• Iloprost has been listed by the FDA as one of the drugs to monitor after having identified potential signs of serious risks or new safety information in the agency's Adverse Event Reporting System (AERS) database during the last 3 months of 2011. Hemoptysis has been reported with iloprost use. The FDA said that it is not suggesting that clinicians should stop prescribing any drugs on the watch list, or that patients should stop taking them. It advises patients with questions about watch-list drugs to discuss them with their clinician.
• Use caution in patients experiencing other types of pulmonary diseases (i.e., COPD)
• Syncope may occur with pulmonary arterial hypertension, particularly with physical exertion (adjust the dose and reassess efficacy)
• Risk of syncope - monitor vital signs when initiating
• Use caution in patients with bleeding disorders
• Rebound hypertension may occur with dose reductions or withdrawals
• Administered only via the Prodose® AAD® System
• Not for use in patients with hypotension (systolic BP below 85 mm Hg)
• Discontinue immediately if signs of pulmonary edema
• Bleeding events are most commonly reported as epistaxis or hemoptysis

Pregnancy & Lactation

• Limited published data from case series and case reports in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; there are risks to mother and fetus associated with pulmonary arterial hypertension
• Pulmonary arterial hypertension in pregnancy increases the risk for maternal heart failure, stroke and death, miscarriage, preterm delivery, low birth weight in infants, and stillbirth

Lactation

• There are no data on the presence of iloprost in human milk, effects on breastfed infants, or milk production; the drug is present in rat milk; when the drug is present in animal milk, it is likely drug will be present in human milk
• Because of the potential for serious adverse reactions, advise women not to breastfeed during treatment