Ventavis

iloprost

(eye-lo-prost) ,

Ventavis

(trade name)

Classification

Therapeutic: vasodilators
Pharmacologic: prostacyclins
Pregnancy Category: C

Indications

Pulmonary arterial hypertension (WHO Group 1).

Action

Dilates pulmonary and arterial vasculature.

Therapeutic effects

Improved exercise capacity.

Pharmacokinetics

Absorption: Unknown.
Distribution: Unknown.
Metabolism and Excretion: Any absorbed iloprost is metabolized.
Half-life: 20–30 min (plasma).

Time/action profile (improved exercise capacity)

ROUTEONSETPEAKDURATION
Inhaln unknownunknownup to 2 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Systolic BP <85 mm Hg; Lactation: Lactation.
Use Cautiously in: Concurrent use of drugs or coexisting medical conditions that may ↑ risk of syncope; COPD, asthma, or acute pulmonary infection (may ↑ risk of bronchospasm); Hepatic impairment (may need to ↑ dosing interval); Pediatric: Safety not established; Obstetric: Use only if maternal benefit outweighs fetal risk.

Adverse Reactions/Side Effects

Central nervous system

  • dizziness
  • fainting
  • headache
  • insomnia

Ear, Eye, Nose, Throat

  • epistaxis

Respiratory

  • cough (most frequent)
  • bronchospasm
  • dyspnea
  • hemoptysis
  • wheezing

Cardiovascular

  • HF (life-threatening)
  • vasodilation (most frequent)
  • chest pain
  • hypotension
  • peripheral edema
  • supraventricular tachycardia

Gastrointestinal

  • diarrhea
  • gingival bleeding
  • nausea
  • vomiting

Genitourinary

  • renal failure

Dermatologic

  • facial flushing

Musculoskeletal

  • back pain
  • jaw-muscle spasm
  • muscle cramps

Interactions

Drug-Drug interaction

↑ risk of hypotension with other vasodilators or diuretics.Risk of bleeding may be ↑ by anticoagulants.

Route/Dosage

Inhalation (Adults) 2.5 mcg initially, then 5 mcg/dose 6–9 times daily; not more than every 2 hr.

Hepatic Impairment

Inhalation (Adults) Child Pugh Class B or C—Consider ↑ dosing interval to every 3–4 hr.

Availability

Solution for inhalation: 10 mcg/mL ampules, 20 mcg/mL ampules

Nursing implications

Nursing assessment

  • Assess respiratory status (exercise intolerance, symptoms, deterioration) prior to and periodically during therapy.
  • Monitor vital signs prior to and throughout therapy. Do not administer if BP <85 mm Hg.
  • Assess for signs of pulmonary edema (dyspnea, jugular venous distension). If signs occur, discontinue iloprost immediately; may be a sign of pulmonary venous hypertension.

Potential Nursing Diagnoses

Activity intolerance (Indications)
Ineffective breathing pattern (Indications)

Implementation

  • Avoid iloprost contact with skin or eyes, or oral ingestion.
  • Inhalation: Prepare medication by one ampule of iloprost into Prodose ADD System or I-neb ADD system medication chamber immediately before use. Do not mix with other medications. Administer 6–9 times/day during waking hours, according to patient's needs and tolerability. Discard solution remaining in chamber after inhalation. Follow manufacturer's instructions for cleaning components after administration of each dose.

Patient/Family Teaching

  • Instruct patient in use of iloprost and Prodose ADD System or I-neb ADD system, frequency, ampule dispensing, and cleaning of equipment. See manufacturer's instructions. Advise patient that inhalation intervals should not be less than 2 hr, but acute benefits of medication may not last 2 hr.
  • May cause dizziness and fainting due to hypotension. Caution patient to change positions slowly to minimize orthostatic hypotension.

Evaluation/Desired Outcomes

  • Improved exercise tolerance, decrease in symptoms of pulmonary edema, and lack of deterioration in patients with pulmonary arterial hypertension.

Ventavis

a brand name for ILOPROST TROMETAMOL.
References in periodicals archive ?
In coming two to four years the exclusivity of key brands such as Tracleer, Remodulin, Adcirca, Ventavis, Tyvaso, and Letairis will be lost.
Actelion Acquisition: The acquisition gives JNJ five currently-marketed therapies (Opsumit, Tracleer, Uptravi, Veletri and Ventavis) for the treatment of pulmonary hypertension and two currently-marketed specialty products, Valchlor gel (cutaneous T-cell lymphoma) and Zavesca (Gaucher disease in the U.S./Nieman-Pick disease in Europe).
Breelib is a new nebuliser for Ventavis. It has been developed by Bayer in collaboration with Vectura, adapting Vectura's FOX handheld smart nebuliser device, and leveraging its unique flow rate and volume control technology.
Treatment options for pulmonary hypertension associated with scleroderma include the endothelin receptor antagonist bosentan (Tracleer); the phosphodiesterase inhibitors sildenafil (Revatio), vardenafil (Levitra) or tadalafil (Adcicra); and various prostacyclin analogs, such as epoprostenol (Flolan), treprostinil (Remodulin) and iloprost (Ventavis).
Actelion is a highly profitable life science firm as a result of our leading franchise in pulmonary arterial hypertension (PAH), where our three marketed products Tracleer, Ventavis and Veletri continue to bring significant value to patients.
Bronchoscopies, along with biopsies of standard endobronchial sites and any other abnormal-appearing areas, were performed at baseline and at 6 months after randomization to treatment with iloprost (Ventavis) or placebo in a phase II chemoprevention trial involving 152 former or current smokers with at least a 20-pack-year history.
Drug administration and dosages may include Flolan or epoprostenol, via continuous IV infusion via central venous catheter using an ambulatory infusion pump 1 to 20 ng/kg/min, treprostinil (Remodulin), continuous subcutaneous infusion 0.625 to 1.25 ng/kg/min, and iloprost (Ventavis) via inhalation, nebulizer (using one of two approved drug delivery devices) 2.5 to 5 meg, 6-9 times/day.
The FDA also approved three more drugs, Remodulin, Ventavis, and Revatio in 2002, 2004 and 2005 respectively for the treatment of PAH.
Ventavis, which was recently approved by the FDA for the treatment of pulmonary arterial hypertension (World Health Organization Group I), or PAH, in patients with New York Heart Association Class III or IV symptoms.