alprostadil (systemic)

CV: arrhythmia, bradycardia, edema, heart block, heart failure, hypotension, tachycardia

Derm: flushing

F and E: hypokalemia

GI: diarrhea, gastric regurgitation, hyperbilirubinemia, peritonitis

GU: anuria, hematuria

Hemat: anemia, bleeding, disseminated intravascular coagulation, thrombocytopenia

Metab: hypoglycemia

MS: neck hyperextension, stiffness

Neuro: cerebral bleeding, irritability, jitteriness, lethargy, SEIZURES

Resp: apnea, altered respiratory rate (slow and fast), hypercapnia, respiratory depression, wheezing

Misc: fever, hypothermia, sepsis

Interactions ⬆ ⬇

Drug-drug:

Risk of bleeding may be ↑ by concurrent use of anticoagulants, some cephalosporins, or antiplatelet agents. Concurrent use of epinephrine, or phenylephrine may ↓ effectiveness of alprostadil.
Concurrent use with other vasodilators↑ risk of hypotension.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 500 mcg/mL

Route/Dosage ⬆ ⬇

IV IA (Neonates ): 0.05–0.1 mcg/kg/min initially; may be ↑ up to 0.4 mcg/kg/min until satisfactory response, then ↓ to maintenance dose by halving infusion rate. In some patients lower doses (0.01 mcg/kg/min) may be sufficient.

US Brand Names ⬆ ⬇

Prostin VR Pediatric

Action ⬆ ⬇

IV: Directly relaxes smooth muscle of the ductus arteriosus.

Therapeutic effects:

IV: Short-term maintenance of patent ductus arteriosus in neonates born with congenital heart defects who require patency to maintain blood oxygenation and perfusion of the lower body.

Classifications ⬆ ⬇

Therapeutic Classification: ductus arteriosus patency adjuncts

Pharmacologic Classification: prostaglandins

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Up to 80% rapidly metabolized in the lungs.

Half-Life: 5–10 min.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(improvement in blood gases, pulmonary blood flow )

ROUTE	ONSET	PEAK	DURATION
IV (ACHD‡)	1.5–3 hr	15 min–11 hr	duration of infusion
IV (CCHD‡)	15–30 min	30 min	duration of infusion

‡Acyanotic congenital heart disease.

‡Cyanotic congenital heart disease.

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Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇