Epoprostrenol
Synonym :
Prostacyclin
Mechanism :
Epoprostenol (prostacyclin), a metabolite of arachidonic acid, is a naturally occurring prostaglandin with potent vasodilatory activity and inhibitory activity of platelet aggregation. Epoprostenol has two major actions, direct vasodilation of pulmonary and systemic arterial vascular beds, and inhibition of platelet aggregation.
Indication :
Contraindications :
Chronic use is contraindicated in patients with CHF due to severe left ventricular systolic dysfunction. Some patients with pulmonary hypertension have developed pulmonary edema during dose initiation, which may be associated with pulmonary veno-occlusive disease. Also contraindicated in patients with known hypersensitivity to the drug or to structurally-related compounds.
Dosing :
Start with 2 ng/kg/min as an intravenous infusion over 1-2 days. Adjust dose by 1-2 ng/kg/min every 15 minutes or longer until desired effect is seen or maximum dose is reached.
Adverse Effect :
Nausea, vomiting, headache, hypotension, flushing, anxiety, chest pain, bradycardia, dyspnea, dizziness, musculoskeletal pain, abdominal pain, tachycardia. Chronic use has led to right ventricular failure, and pallor.
Interaction :
Diuretics, antihypertensive agents, or other vasodilators: Additional reductions in blood pressure
Antiplatelet agents or anticoagulants: increase the risk of bleeding
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unknown dialysability. Dose as in normal renal function |
| HD | Unknown dialysability. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.