Pregnancy Category: C
Pulmonary arterial hypertension (WHO Group 1).
Dilates pulmonary and arterial vasculature.
Improved exercise capacity.
Metabolism and Excretion: Any absorbed iloprost is metabolized.
Half-life: 20–30 min (plasma).
Time/action profile (improved exercise capacity)
|Inhaln||unknown||unknown||up to 2 hr|
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
Ear, Eye, Nose, Throat
- cough (most frequent)
- HF (life-threatening)
- vasodilation (most frequent)
- chest pain
- peripheral edema
- supraventricular tachycardia
- gingival bleeding
- renal failure
- facial flushing
- back pain
- jaw-muscle spasm
- muscle cramps
Drug-Drug interaction↑ risk of hypotension with other vasodilators or diuretics.Risk of bleeding may be ↑ by anticoagulants.
Inhalation (Adults) 2.5 mcg initially, then 5 mcg/dose 6–9 times daily; not more than every 2 hr.
Hepatic ImpairmentInhalation (Adults) Child Pugh Class B or C—Consider ↑ dosing interval to every 3–4 hr.
Solution for inhalation: 10 mcg/mL ampules, 20 mcg/mL ampules
- 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 DiagnosesActivity intolerance (Indications)
Ineffective breathing pattern (Indications)
- 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.
- 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.
- Improved exercise tolerance, decrease in symptoms of pulmonary edema, and lack of deterioration in patients with pulmonary arterial hypertension.