Epoprostenol
- Atc Codes:B01AC09
- CAS Codes:35121-78-9#61849-14-7
- PHARMGKB ID:35121-78-9#61849-14-7
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Flolan; Belgium: Flolan; Czech Republic: Flolan; Denmark: Flolan; Estonia: Flolan; France: Flolan; Greece: Flolan; Ireland: Flolan; Italy: Flolan; Luxembourg: Flolan; Malta: Flolan; Netherlands: Flolan; Poland: Flolan; Spain: Flolan; UK: Flolan.
North America
Canada: Flolan; USA: Epoprostenol, Flolan.
Asia
Japan: Flolan.
Drug combinations
Chemistry
Epoprostenol: C~20~H~32~O~5~. Mw: 352.47. (1) Prosta-5,13-dien-1-oic acid, 6,9-epoxy-11,15-dihydroxy-, (5Z,9α,11α,13E,15S)-; (2)(Z)-(3aR,4R,5R,6aS)-Hexahydro-5-hydroxy-4-[(E)-(3S)-3-hydroxy-1-octenyl]-2H-cyclopenta[b]furan-Δ^2,Δ^-valeric acid. CAS-35121-78-9 (1979).
Epoprostenol Sodium: C~20~H~31~NaO~5~. Mw: 374.45. Prosta-5,13-dien-1-oic acid, 6,9-epoxy-11,15-dihydroxy-, sodium salt, (5Z,9α,11α,13E,15S)-. CAS-61849-14-7 (1980).
Pharmacologic Category
Vasodilating Agents, Miscellaneous; Prostacyclin; Prostaglandin. (ATC-Code: B01AC09).
Mechanism of action
Epoprostenol, a naturally occurring prostaglandin, is a short-acting vasodilating agent and a platelet-aggregation inhibitor. This effect results from its activation of intracellular adenylate cyclase and the resultant increase in cAMP concentrations within the platelets.
Therapeutic use
Treatment of idiopathic pulmonary arterial hypertension and pulmonary hypertension associated with the scleroderma spectrum of disease.
Pregnancy and lactiation implications
Safety and efficacy during labor, vaginal delivery, or cesarean section not established. Unknown whether epoprostenol is distributed into milk. Use with caution in nursing women.
Unlabeled use
Contraindications
Hypersensitivity to epoprostenol or to structurally-related compounds. Chronic use in CHF due to severe left ventricular systolic dysfunction. Patients who develop pulmonary edema during dose initiation.
Warnings and precautions
Avoid abrupt discontinuance or sudden large reductions in infusion rates (may result in symptoms associated with rebound pulmonary hypertension, including dyspnea, dizziness, and asthenia). Risk of pulmonary thromboembolism or systemic embolism associated with the permanent indwelling central venous catheter. Some patients with primary pulmonary hypertension developed pulmonary edema during dosing adjustment (may be associated with pulmonary veno-occlusive disease). Use with caution in risk factors for bleeding. During chronic use, unless contraindicated, anticoagulants should be co-administered to reduce risk of thromboembolism. Chronic continuous I.V. infusion of epoprostenol via a chronic indwelling central venous catheter associated with local infections and serious blood stream infections.