Adult Dosing
Pulmonary arterial hypertension
- Start 2.5 mcg (as delivered at the mouthpiece)
- If this dosage is well tolerated, titrate the dose to 5 mcg and maintain at that dose; otherwise maintain at 2.5 mcg
- Take the dose 6-9 times/day (not more than once every 2 hrs) during waking hours
- Max: 45 mcg/day (5 mcg 9x/day)
Notes:- Do not initiate the therapy if systolic blood pressure <85 mmHg
- Do not mix with other nebulized medications
- Use with recommended nebulizer only
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Avoid contact with the skin or eyes and avoid oral ingestion of iloprost solution
- Risk of syncope exists with iloprost administration; syncope may also occur in association with pulmonary arterial hypertension, particularly with physical exertion. Monitor vital signs at treatment initiation; do not start therapy if systolic blood pressure <85 mmHg
- Discontinue therapy in patients with pulmonary hypertension when signs of pulmonary edema occur, as this could be a sign of pulmonary venous hypertension
- Therapy may cause bronchospasm, which may be severe or frequent in patient with a history of hyper-reactive airways. Safety of iloprost has not been established in patients with chronic obstructive pulmonary disease (COPD), severe asthma, or with acute pulmonary infections
Cautions: Use cautiously in
- ESRD with dialysis
- Child-Pugh class B or C
- Hypotension
- Elderly patients
Supplemental Patient Information
- Advise patients that the therapy may be associated with a fall in blood pressure, so they may become dizzy or even faint
- Instruct patients to stand up slowly when they get out of a chair or bed; advise them to consult their physicians if fainting gets worse
Pregnancy Category:C
Breastfeeding: Safety unknown. As per manufacturer's data, because of the potential for possible serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or to discontinue the drug, analyzing the importance of the drug to the mother.
