Epoprostenol (prostacyclin)

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Epoprostenol = prostacyclin (naturally-occurring PGI2) in medication form

Administration

  • Type: Prostaglandin
  • Dosage Forms:
  • Routes of Administration: IV, nebulized
  • Common Trade Names: Flolan

Adult Dosing

  • IV: 2 ng/kg/min initially, titrate upward by 2 ng/kg/min q15m until intolerance or dose-limiting effects occur. Avoid abrupt withdrawal: gradually decrease dose by 2ng/kg/min q15min.
  • Nebulized: dosing not well standardized, usually 12.5-50 ng/kg/min

Pediatric Dosing

Safety/efficacy not well established (though some PICUs do use it)

Special Populations

Renal Dosing

  • Adult:
  • Pediatric:

Hepatic Dosing

  • Adult:
  • Pediatric:

Contraindications

  • Allergy to class/drug
  • LV failure

Adverse Reactions

Serious

  • Hemorrhage
  • Hypersplenism
  • Infection

Common

  • Tachycardia, bradyarrythmia
  • Hypotension
  • Nausea/vomiting, diarrhea, abdominal pain
  • Flushing
  • Headache, dizziness
  • Musculoskeletal pain

Pharmacology

  • Half-life: ~6 min
  • Metabolism: Extensively and rapidly metabolized in blood
  • Excretion: Mostly renal

Mechanism of Action

  • Prostaglandin→ stimulates vasodilation of pulmonary and systemic arteries. Also inhibits platelet aggregation.

Comments

See Also

References

Authors:

Claire