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 ?
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.
The FDA also approved three more drugs, Remodulin, Ventavis, and Revatio in 2002, 2004 and 2005 respectively for the treatment of PAH.
Ventavis is an inhaled formulation of iloprost, a synthetic compound that is structurally similar to prostacyclins (naturally occurring molecules that cause blood vessels to dilate).
as the Ventavis Inhalant Solution under exclusive contract with Schering AG, which markets the drug in Europe and Australia.
LONDON -- Iloprost (also called Ventavis, Ilomedin) is artificial prostacylin (PGI2) that is specifically indicated for the treatment of pulmonary arterial hypertension.
Actelion has received a warning letter in which the FDA criticised that the Swiss company did not report about side effects and death cases among patients which were taking its drugs Tracleer, Ventavis and Zavesca.
The various drugs used to treat PAH are: Tracleer (bosentan), Letairis (ambrisentan), Remodulin (treprostinil), Ventavis (iloprost), Revatio (sildenafil), Adcirca (tadalafil), Tyvaso (inhaled treprostinil), and Veletri (epoprostenol).
The current branded drugs are Lipitor (atorvastatin), Plavix (clopidogrel), Ventavis (iloprost) and Crestor (rosuvastatin).
The history behind Bayer's Ventavis inhalation solution, launched in 2004, is an example of how a company which is not involved in the development of a marketed drug is able to capitalise on its success.
Ventavis (iloprost) is an inhaled formulation of iloprost, approved for the treatment of pulmonary arterial hypertension.
Ventavis (iloprost) from CoTherix, an inhalation solution for the treatment of PAH in patients with NYHA Class III or IV symptoms, launched in March 2005.
CoTherix markets Ventavis for pulmonary arterial hypertension (PAH), as well as having a potential big drug in mid-stage trials called Fasudil.