Generic Name

Iloprost

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Classification

FDA Approved Indications

• Pulmonary arterial hypertension (WHO Group 1)

Mechanism of Action

Iloprost mimics prostacyclin, leading to vasodilation of pulmonary and systemic arterial vascular beds. It inhibits platelet aggregation and has anti-inflammatory effects.

Dosage and Administration

Adult: Typically, inhalation via nebulizer 5 micrograms 6-9 times daily, titrated based on response.

Pediatric: Limited data; use with caution and under specialist supervision.

Geriatric: Adjust as needed based on response and tolerability.

Renal Impairment: No specific adjustment recommended; monitor response.

Hepatic Impairment: Limited data; exercise caution and monitor closely.

Pharmacokinetics

Absorption: Rapid absorption via inhalation.

Distribution: Widely distributed with high pulmonary selectivity.

Metabolism: Primarily metabolized by plasma esterases.

Excretion: Excreted mainly as metabolites in urine.

Half Life: 3-5 minutes (short duration, requires frequent dosing)

Contraindications

• Hypersensitivity to iloprost or prostacyclin analogs.
• Severe hypotension.

Precautions

• Use with caution in patients with bleeding disorders, recent surgery, or on other antiplatelet/anticoagulant therapies.
• Caution in patients with asthma or COPD due to potential airway irritation.

Adverse Reactions - Common

• Cough, throat irritation (Common)
• Jaw pain, headache (Common)
• Flushing, hypotension (Common)

Adverse Reactions - Serious

• Gastrointestinal bleeding (Rare)
• Sudden drop in blood pressure (Rare)
• Worsening pulmonary hypertension or right heart failure (Rare)

Drug-Drug Interactions

• Other vasodilators, antihypertensives, anticoagulants, antiplatelet agents

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Use exactly as prescribed.
• Report any signs of bleeding, significant dizziness, or worsening symptoms.
• Maintain regular follow-up and monitoring.

Special Considerations

Black Box Warnings:

• Potential for hypotension leading to syncope or ischemia.

Genetic Factors: No known genetic factors affecting response.

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Severe hypotension, dizziness, syncope.

Treatment: Discontinue drug, provide supportive care, administer IV fluids or vasopressors if needed.

Storage and Handling

Storage: Store unopened vials in refrigeration at 2-8°C. Once opened, use within 24 hours at room temperature.

Stability: Stable when stored properly, used within specified time after opening.