Adult Dosing
Primary pulmonary hypertension (PPH)/pulmonary hypertension associated with scleroderma spectrum of disease in New York Heart Association (NYHA) class III and class IV patients
- Start: 2 ng/kg/min; may increase by 2 ng/kg/min q15 mins or more until dose-limiting adverse effects/tolerance limit to the drug are noted
- Decrease infusion rate by 2 ng/kg/min at intervals of at least 15 min if dose-limiting adverse effects occur
Note: Changes in infusion rate should be based upon persistence, recurrence, or worsening of symptoms and/or emergence of adverse reactions. Abrupt withdrawal or large reductions in infusion rate should be avoided.
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- It must be reconstituted only as directed. Do not reconstitute or mix with any other parenteral medications or solutions prior to or during administration
- Administer under supervision of clinicians experienced in the diagnosis and treatment of pulmonary hypertension
- Make sure that adequate personnel and equipment for physiologic monitoring and emergency care are appropriate prior to initiate the therapy
- Continuously deliver on an ambulatory basis through a permanent indwelling central venous catheter during chronic use
- Dosage of the drug during chronic use should be adjusted at the first sign of recurrence or worsening of symptoms. After dosage adjustments, standing and supine blood pressure and heart rate should be monitored closely for several hours
- Abrupt withdrawal (including interruptions in drug delivery) or sudden large reductions in dosage of the drug may result in symptoms associated with rebound pulmonary hypertension, including dyspnea, dizziness, and asthenia, and therefore should be avoided
- Additional reductions in blood pressure may occur when the drug is administered with diuretics, antihypertensive agents, or other vasodilators
- Administer anticoagulant therapy to reduce the risk of pulmonary thromboembolism or systemic embolism
- Use aseptic techniques to reduce the risk of infection
Caution: Use cautiously in
Pregnancy Category:B
Breastfeeding: It is not known whether epoprostenol is excreted in human milk. Manufacturer advised caution while administering to a nursing woman.
