EPOPROSTENOL

COMMON BRAND NAME(S): Flolan

GENERIC NAME(S): EPOPROSTENOL SODIUM (ARGININE)

 

Description: Epoprostenol, a metabolite of aracidonic acid, is a naturally occuring prostaglandin that relaxes the blood vessels in the lungs and other parts of the body, and inhibits platelet clumping so that blood can flow more easily.

Indications:

This medication is used to treat high blood pressure in the lungs  known as pulmonary arterial hypertension. It helps to increase your ability to exercise and improve symptoms such as shortness of breath and tiredness.

Contraindications:

Should not be given to patients with heart failure and known allergic reaction to this drug or any of its component.

How to use epoprostenol (arginine) intravenous

Dosage:

Usual adult dose is in an acute dose ranging and continuous dose.

Acute Dose Ranging: 2 ng/kg/min and increased in increments of 2 ng/kg/min every 15 minutes or longer.

The mean maximum dose which is not toxic  is 8.6 ng/kg/min.

Continuous Chronic Infusion: 4 ng/kg/min less than the maximum tolerated infusion rate determined during acute dose ranging.
If the maximum tolerated infusion rate is less than 5 ng/kg/min, the chronic infusion should be started at one-half the maximum tolerated infusion rate. During clinical trials, the mean initial chronic infusion rate was 5 ng/kg/min.

  • Epoprostenol is given as an intravenous (IV) infusion. If you will be using epoprostenol at home, a health care provider will teach you how to use it.
  • Epoprostenol must be mixed with a certain type of solution. Do not use any other type of solution to mix epoprostenol.

Please see Precautions section.

You should check with your doctor immediately if any of these side effects occur when taking epoprostenol:

More common

  • Abdominal or stomach pain
  • arm, back, or jaw pain
  • bladder pain
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • bloody or cloudy urine
  • blurred vision
  • changes in skin color
  • chest congestion
  • chest pain or discomfort
  • chest tightness or heaviness
  • chills
  • cold hands and feet
  • confusion
  • constipation
  • convulsions
  • cough or hoarseness
  • coughing up blood
  • decreased urine
  • depression
  • diarrhea
  • difficult, burning, or painful urination
  • difficulty with breathing or swallowing
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • extreme fatigue
  • fast, pounding, or irregular heartbeat or pulse
  • feeling of warmth
  • fever
  • headache
  • incoherent speech
  • increased menstrual flow or vaginal bleeding
  • increased thirst
  • increased urination
  • local infection at the catheter site
  • loss of appetite
  • metallic taste
  • muscle pain or cramps
  • muscle weakness
  • nausea or vomiting
  • nosebleeds
  • numbness or tingling in the hands, feet, or lips
  • pain at the injection site
  • pain, redness, or swelling in the arm or leg
  • paleness of the skin
  • prolonged bleeding from cuts
  • rapid weight gain
  • red or black, tarry stools
  • redness of the face, neck, arms, and occasionally, upper chest
  • sweating
  • swelling of the face, fingers, feet, or lower legs
  • tightness in the chest
  • tingling of the hands or feet
  • unusual tiredness or weakness
  • weight gain or loss

Some of the side effects that can occur with epoprostenol may not need medical attention.

More common

  • Change in vision
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • heartburn
  • hives or welts
  • impaired vision
  • itching
  • joint pain
  • lack of appetite
  • lack or loss of strength
  • loss of interest or pleasure
  • muscle pains or stiffness
  • redness of the skin
  • shakiness in the legs, arms, hands, or feet
  • skin rash, encrusted, scaly and oozing
  • sores on the skin
  • swollen joints
  • tiredness
  • trembling or shaking of the hands or feet
  • trouble concentrating

Precautions

  • Medical History: Before using this medication, tell your doctor or pharmacist if you had: heart failure (on the left side of the heart), bleeding problems (such as bleeding of the stomach/intestines), blood disorders (such as thrombocytopenia), liver disease.
  • The most common dose-limiting pharmacologic effects (occurring in 1% or more of patients) during dose ranging are nausea, vomiting, headache, hypotension, and flushing, but also include chest pain, anxiety, dizziness, bradycardia, dyspnea, abdominal pain, musculoskeletal pain, and tachycardia.
  • Pulmonary Edema: If patients show symptoms of pulmonary edema, such as breathlessness with usual activity, rapid breathing, dizziness, or weakness.
  • Rebound Pulmonary Hypertension Following abrupt withdrawal: Abrupt withdrawal of epoprostenol or sudden large reductions in infusion rates should be avoided. Except in life-threatening situations.
  • Vasodilation: This drug can cause low blood pressure and other reactions such as flushing, nausea, vomiting, dizziness, or headache.  Monitor blood pressure and symptoms regularly.
  • Bleeding: This drug inhibits platelet clumping, which is essential to stop bleeding.  Expect an increased risk of bleeding complications.

Pregnancy Risk: Category B (No proven risk in humans)

Breastfeeding: It is not known whether this drug is excreted in human milk.

 

Interactions

  • Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: antiplatelet drugs (such as clopidogrel).
  • Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen, naproxen) that can increase the risk of bleeding or medicines (such as cough-and-cold products, diet aids) that could increase your blood pressure or heart rate. Ask your pharmacist about using those products safely.
  • However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately.

Symptoms of overdose may include: severe dizziness. 

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as blood pressure, heart rate) should be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

This drug is to be given continuously as an infusion. If your infusion is interrupted, contact your doctor or pharmacist immediately.

Storage

Store unopened vials at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Consult your pharmacist for details about the storage of opened vials and prepared solutions. Do not freeze. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

 

Brands

There are no brands containing this molecule.

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