Epoprostenol

Information about Epoprostenol

Epoprostenol (e" poe pros' ten nol) is the pharmaceutical name for prostacyclin, a naturally occurring metabolite of arachidonic acid that causes pulmonary arterial vasodilation and inhibits platelet activation.

Epoprostenol structure

Epoprostenol must be given parenterally and has a short half-life (~6 minutes), for which reasons it is administered as a continuous intravenous infusion. In multiple clinical trials in patients with PAH, prolonged epoprostenol infusions led to an increase in exercise capacity (6 minute walk distance), improvement in symptoms and delay in clinical progression in patients with idiopathic and inheritable forms of PAH (WHO Group 1) and connective tissue disease-associated PAH.

FDA approval information for Epoprostenol

Epoprostenol was approved for use in the United States in 1995 and remains available generically and under the brand name Flolan. Epoprostenol is provided as a sterile powder in single use vials of 0.5 or 1.5 mg.

Dosage and administration for Epoprostenol

The typical dose is 2 ng per kg body weight per minute administered via an implanted central venous catheter. The dose can be increased in increments of 1 to 2 ng/kg/min based upon clinical response and tolerance.

Side effects of Epoprostenol

Common side effects include dizziness, jaw pain, headache, muscle pain, gastrointestinal upset, nausea and vomiting, effects commonly associated with vasodilatory therapies. Uncommon, but potentially severe adverse events include pulmonary edema, hypotension, syncope, and bleeding. Sudden discontinuation can lead to rebound pulmonary hypertension. Side effects of the intravenous catheter required for administration include local pain, swelling and infection at the site of injection and catheter-associated bacterial infections that can be severe and result in fatality.

Liver toxicity

Epoprostenol has not been associated with serum enzyme elevations above the rate in control subjects and has not been linked to instances of clinically apparent acute liver injury.

Pulmonary Disease Agents

• Chronic Obstructive Pulmonary Disease (COPD) Agents
  • Anticholinergic Agents
    • Ipratropium, Tiotropium, Aclidinium
  • Beta-2 Adrenergic Agonists
    • Albuterol, Formoterol, Salmeterol, Terbutaline
  • Corticosteroids
    • Budesonide, Fluticasone
  • Miscellaneous
    • Roflumilast, Theophylline

• Pulmonary Arterial Hypertension Agents
  

• • Endothelin Receptor Antagonists
    • • Ambrisentan, Bosentan, Macitentan
  • Phosphodiesterase Type 5 (PDE5) Inhibitors
    • Avanafil, Sildenafil, Tadalafil, Vardenafil
  •  Prostacyclin Analogs
    • Epoprostenol, Iloprost, Treprostinil
  •  Miscellaneous
    • Riociguat, Selexipag

• Pulmonary Fibrosis Agents
  • Nintedanib, Pirfenidone

• Dailymed label info on Epoprostenol
• FDA Epoprostenol

Epoprostenol Resources
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