Epoprostenol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Prevention of platelet aggregation Usual dose for renal dialysis: 4 ng/kg/min before dialysis, then 4 ng/kg/min into the arterial inlet of the dialyser during dialysis.Pulmonary HTN Initial: Give at a rate of 2 ng/kg/minute, then increase by increments of 2 ng/kg/minute at intervals of at least 15 minutes until max haemodynamic benefits/dose-limiting effects occur. Then, may be given at a rate of 4 ng/kg/minute less than the max tolerated infusion rate. If the max rate is <5 ng/kg/minute, then initial rate should be 1/2 of the max rate. Adjust maintenance dose according to response.
Dosage Details
Intravenous
Pulmonary hypertension
Adult: Initially, given at a rate of 2 ng/kg/minute, then increase by increments of 2 ng/kg/minute at intervals of at least 15 minutes until max haemodynamic benefits/dose-limiting effects occur. Then, may be given at a rate of 4 ng/kg/minute less than the max tolerated infusion rate. If the max rate is <5 ng/kg/minute, then initial rate should be 1/2 of the max rate. Adjust maintenance dose according to response. If symptoms recur or if adverse effects occur, increase or decrease dose in steps of 1-2 ng/kg/minute at intervals of at least 15 minutes until a new maintenance dose is established.
Child: Neonates Initially, 2 ng/kg/min given via IV infusion, adjust according to response up to max 20 ng/kg/min. 1 month to 17 years Initially, 2 ng/kg/min given via IV infusion, increase  to 40 ng/kg/min, if necessary. Prolonged treatment may lead to tolerance to epoprostenol and doses up to 120 ng/kg/min may be required.

Intravenous
Prophylaxis of platelet aggregation
Adult: Usual dose for renal dialysis: 4 ng/kg/min via IV inj before dialysis, then 4 ng/kg/min into the arterial inlet of the dialyser during dialysis.
Contraindications
Hypersensitivity; severe left ventricular dysfunction.
Special Precautions
Elderly, pregnancy and lactation; haemorrhagic diathesis. Avoid abrupt interruptions or sudden dosage changes as it may cause rebound pulmonary hypertension. Avoid extravasation. Anticoagulant monitoring required when given with heparin. Dose titration for pulmonary hypertension should be in hospital (risk of pulmonary oedema). Monitor haematological and CV function.
Adverse Reactions
Hypotension, bradycardia, pallor, sweating, headache, tachycardia, pulmonary oedema; flushing; GI disturbances; lassitude; jaw pain, myalgia, tremor; anxiety; nervousness; drowsiness; chest pain; dry mouth, hyperglycaemia and inj site reactions; flu-like symptoms; erythema over the infusion site.
IV/Parenteral: B
Overdosage
Symptoms include flushing, headache, hypotension, tachycardia, nausea, vomiting and diarrhoea. Treatment is symptomatic and supportive and includes reducing dose or discontinuing the drug.
Drug Interactions
Enhanced hypotensive effects by other vasodilators, diuretics, acetate in dialysis fluids. Increased risk of bleeding with anticoagulants and antiplatelet.
Action
Description: Epoprostenol has vasodilating and antiplatelet properties. It activates intracellular adenylate cyclase and increases the conc of cyclic adenosine monophosphate (cAMP) in platelets, thus reducing platelet aggregation. It also decreases thrombogenesis and platelet clumping.
Storage
Store at 15-25°C.
Disclaimer: This information is independently developed by MIMS based on Epoprostenol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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