Formulary
Iloprost: Indications, Dosing, Side Effects and Interactions
Iloprost clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Iloprost: Indications, Dosing, Side Effects and Interactions
Iloprost clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Idiopathic or familial pulmonary arterial hypertension (initiated under specialist supervision)**
- **Adult** (By Inhalation Of Nebulised Solution): Initially 2.5 micrograms for 1 dose, increased to 5 micrograms for 1 dose, increased if tolerated to 5 micrograms 6-9 times a day, adjusted according to response; reduced if not tolerated to 2.5 micrograms 6-9 times a day, reduce to lower maintenance dose if high dose not tolerated.
**Severe Raynaud's phenomenon in patients with progressive trophic disorders**
- **Adult** (By Intravenous Infusion): Initially 0.5 nanogram/kg/minute for 30 minutes, then increased, if tolerated, in steps of 0.5 nanogram/kg/minute every 30 minutes (max. per dose 2 nanograms/kg/minute); usual dose 1.5-2 nanograms/kg/minute given over 6 hours daily for 5 days, repeat cycles should take place at intervals of at least 4 weeks (preferably 6-12 weeks).
**Severe chronic lower limb ischaemia**
- **Adult** (By Intravenous Infusion): Initially 0.5 nanogram/kg/minute for 30 minutes, then increased, if tolerated, in steps of 0.5 nanogram/kg/minute every 30 minutes (max. per dose 2 nanograms/kg/minute); usual dose 0.5-2 nanograms/kg/minute given over 6 hours daily for up to 4 weeks.
**Idiopathic or familial pulmonary arterial hypertension (initiated under specialist supervision) for iloprost**
- **Child 8-17 years** (By inhalation of nebulised solution): Initially 2.5 micrograms for 1 dose, increased to 5 micrograms for 1 dose, increased if tolerated to 5 micrograms 6-9 times a day, adjusted according to response; reduced if not tolerated to 2.5 micrograms 6-9 times a day, reduce to lower maintenance dose if high dose not tolerated.
**Raynaud's syndrome for iloprost**
- **Child 12-17 years** (By intravenous infusion): Initially 0.5 nanogram/kg/minute, increased to 1-2 nanograms/kg/minute given over 6 hours daily for 3-5 days, dose increase should be performed gradually.
Cautions
General cautions: Hypotension Specific cautions: When used by inhalation Acute pulmonary infection; chronic obstructive pulmonary disease; severe asthma With intravenous use Significant heart disease
Contraindications
General contra-indications: Conditions which increase risk of haemorrhage; congenital or acquired valvular defects with myocardial function disorders (not related to pulmonary hypertension); decompensated heart failure (unless under close medical supervision); severe arrhythmias; severe coronary heart disease; unstable angina; within 3 months of cerebrovascular events; within 6 months of myocardial infarction Specific contra-indications: When used by inhalation Pulmonary veno-occlusive disease; systolic blood pressure below 85 mmHg; unstable pulmonary hypertension with advanced right heart failure With intravenous use Acute or chronic congestive heart failure (NYHA II-IV); pulmonary oedema
Side effects
General side-effects: Common or very common Cough; diarrhoea; dizziness; dyspnoea; haemorrhage; hypotension; nausea; pain; palpitations; syncope; vomiting Uncommon Taste altered; thrombocytopenia Specific side-effects: Common or very common When used by inhalation Chest discomfort; headache; oral disorders; rash; tachycardia; throat complaints; vasodilation With intravenous use Angina pectoris; anxiety; appetite decreased; arrhythmias; arthralgia; asthenia; bradyphrenia; chills; confusion; drowsiness; feeling hot; fever; flushing; gastrointestinal discomfort; headaches; hyperhidrosis; muscle complaints; sensation abnormal; thirst; vertigo Uncommon With intravenous use Asthma; cerebrovascular insufficiency; constipation; depression; dry mouth; dysphagia; dysuria; embolism and thrombosis; eye discomfort; hallucination; heart failure; hepatic impairment; myocardial infarction; pruritus; pulmonary oedema; renal pain; seizure; tetany; tremor; vision blurred Frequency not known When used by inhalation Respiratory disorders
Interactions
**Other interactions (1):**
- 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,...
Pregnancy
When used by inhalation: Use if potential benefit outweighs risk. With intravenous use: Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
Manufacturer advises caution (risk of increased exposure). Dose adjustments When used by inhalation: Manufacturer advises initial dose reduction to 2.5 micrograms at intervals of 3-4 hours (max. 6 times daily), adjusted according to response-consult product literature. With intravenous use: Manufacturer advises initial dose reduction in severe impairment, consider half the normal dose.
Medicinal forms
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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