Epoprostenol (prostacyclin)
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
- Pregnancy Rating: B
- Lactation risk: Infant risk cannot be ruled out
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.