Formulary
Epoprostenol: Indications, Dosing, Side Effects and Interactions
Epoprostenol is a prostaglandin and a potent vasodilator.
MedNext Academy | 3 min read
Epoprostenol: Indications, Dosing, Side Effects and Interactions
Epoprostenol is a prostaglandin and a potent vasodilator.
Drug action
Epoprostenol is a prostaglandin and a potent vasodilator. It is also a powerful inhibitor of platelet aggregation.
Indications and dose
**Persistent pulmonary hypertension of the newborn for epoprostenol**
- **Neonate** (By continuous intravenous infusion): Initially 2 nanograms/kg/minute, increased if necessary up to 20 nanograms/kg/minute, dose adjusted according to response, rarely doses up to 40 nanograms/kg/minute are used.
**Idiopathic pulmonary arterial hypertension for epoprostenol**
- **Child** (By continuous intravenous infusion): Initially 2 nanograms/kg/minute, increased if necessary up to 40 nanograms/kg/minute.
Cautions
Avoid abrupt withdrawal when used for primary pulmonary hypertension (risk of rebound pulmonary hypertension); extreme caution in coronary artery disease; haemorrhagic diathesis; pulmonary veno-occlusive disease; reconstituted solution highly alkaline-avoid extravasation (irritant to tissues); risk of pulmonary oedema (dose titration for pulmonary hypertension should be in hospital)
Contraindications
Severe left ventricular dysfunction
Side effects
Common or very common Abdominal pain; anxiety; arrhythmias; arthralgia; chest discomfort; diarrhoea; flushing; haemorrhage; headache; intracranial haemorrhage; nausea; pain; rash; sepsis; vomiting Uncommon Dry mouth; hyperhidrosis Rare or very rare Fatigue; hyperthyroidism; intravenous catheter occlusion; local infection; pallor Frequency not known Ascites; pulmonary oedema (avoid chronic use if occurs during dose titration); spleen abnormalities
Interactions
**Other interactions (3):**
- Combinations requiring caution Combinations which can increase the effects of digoxin when co-administered: amiodarone, canagliflozin, daclatasvir, flibanserin, flecainide, prazosin, propafenone,...
- Potential additive effect with platelet aggregation inhibitors: Because of the increased risk of bleeding, the concomitant administration of a platelet aggregation inhibitor (such as clopidogrel,...
- Anticoagulants, platelet inhibitors, etc: Increased risk of bleeding with oral anticoagulants, epoprostenol, clopidogrel, ticlopidine, streptokinase, dipyridamole, dextran solutions, abciximab,...
Pregnancy
Use if potential benefit outweighs risk.
Breast feeding
Manufacturer advises avoid-no information available.
Medicinal forms
Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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