• Pulmonary arterial hypertension (WHO Group 1).

Contraindicated in:

• Hypersensitivity to epoprostenol or similar compounds
• HF due to severe left ventricular systolic dysfunction
• Patients who develop pulmonary edema during dose initiation.

Use Cautiously in:

• OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
• Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant
• Pedi: Safety and effectiveness not established in children.
• Geri: Dose adjustments may be necessary in older adults

CV: chest pain, hypotension, tachycardia, bradycardia.

Derm: flushing, rash, sweating.

GI: abdominal pain, diarrhea, nausea, vomiting.

Hemat: bleeding, thrombocytopenia.

Local: injection site reactions.

MS: jaw pain, myalgia.

Neuro: anxiety, dizziness, headache, hypoesthesia/hyperesthesia/paresthesia.

Resp: dyspnea, pulmonary edema.

Misc: flu-like symptoms.

Drug-Drug:

• Additive hypotension may occur with antihypertensives, diuretics, or other vasodilators.
• Although concurrent use is common and accepted, risk of bleeding may be ↑ by anticoagulants or other agents affecting platelet function.
• May ↑ levels of digoxin.

(Generic available)

• Powder for injection: 0.5 mg/vial; 1.5 mg/vial;

• IV (Adults): Initiate at 2 ng/kg/min; may ↑ by 1–2 ng/kg/min every 15 min or longer until adequate clinical response. If dose-limiting adverse effects occur, infusion rate may be ↓ in decrements of 2 ng/kg/min at intervals of at least 15 min. 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.

Flolan, Veletri

• A prostaglandin that directly dilates pulmonary and systemic arterial vasculature.
• Also inhibits platelet aggregation.

• Improved exercise capacity.

Therapeutic Classification: vasodilators

Pharmacologic Classification: prostaglandins, vasodilators

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Rapidly and extensively degraded in plasma; some metabolites are pharmacologically active.

Half-life: ≤6 min.

Caripul

(hemodynamic effects)

†Following discontinuation.

• Home Care Issues: Instruct patient on reconstitution, administration, and care of the permanent central venous catheter.
• Advise patient of the importance of continuous therapy. Inform patient that even brief interruptions of the infusion may cause symptoms of rebound pulmonary hypertension (dyspnea, dizziness, asthenia). Provide patient with access to a backup infusion pump and intravenous infusion sets to prevent potential interruptions in drug delivery. Also inform patients that therapy may be prolonged, possibly lasting years.
• Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

e-poe-PROSS-te-nole

NDC Code^*

• 0173- GlaxoSmithKline LLC
  • 0173-0517- FLOLAN
    • 0173-0517-00- 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 CARTON (0173-0517-00)

• 0173- GlaxoSmithKline LLC
  • 0173-0519- FLOLAN
    • 0173-0519-00- 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 CARTON (0173-0519-00)

• 0703- Teva Parenteral Medicines, Inc.
  • 0703-1985- Epoprostenol Sodium
    • 0703-1985-01- 1 VIAL in 1 CARTON (0703-1985-01) > 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL

• 0703- Teva Parenteral Medicines, Inc.
  • 0703-1995- Epoprostenol Sodium
    • 0703-1995-01- 1 VIAL in 1 CARTON (0703-1995-01) > 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL

• 66215- Actelion Pharmaceuticals US, Inc.
  • 66215-402- Veletri
    • 66215-402-01- 1 VIAL in 1 CARTON (66215-402-01) > 10 mL in 1 VIAL

• 66215- Actelion Pharmaceuticals US, Inc.
  • 66215-403- Veletri
    • 66215-403-01- 1 VIAL in 1 CARTON (66215-403-01) > 10 mL in 1 VIAL