iloprost (Rx)

Brand and Other Names:Ventavis
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

single-use ampule

  • 10mcg/mL (1mL)
  • 20mcg/mL (1mL)
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Pulmonary Arterial Hypertension

Initial: 2.5 mcg inhaled, if well-tolerated, THEN

5 mcg subsequent doses

6-9 times/d PRN; >q2hr while awake

Maintenance: 2.5-5 mcg/dose; not to exceed 45mcg/day

Administration

Inhaled using Prodose® AAD® System

Use during waking hours

Safety and efficacy not established

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Interactions

Interaction Checker

and iloprost

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Flushing (18%)

            Cough (39%)

            Hypotension (11%)

            Nausea (13%)

            Headache (30%)

            Jaw pain (12%)

            Trismus (12%)

            1-10%

            Palpitations (7%)

            Syncope (8%)

            Insomnia (8%)

            Vomiting (7%)

            Tongue pain (4%)

            Back pain (7%)

            Muscle cramps (6%)

            GGT elevated (6%)

            Hemoptysis (5%)

            Pneumonia (4%)

            <1%

            Kidney failure

            Bronchospasm

            Hypersensitivity

            Supraventricular tachycardia

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            Warnings

            Contraindications

            None well documented

            Cautions

            Iloprost has been listed by the FDA as one of the drugs to monitor after having identified potential signs of serious risks or new safety information in the agency's Adverse Event Reporting System (AERS) database during the last 3 months of 2011. Hemoptysis has been reported with iloprost use. The FDA said that it is not suggesting that clinicians should stop prescribing any drugs on the watch list, or that patients should stop taking them. It advises patients with questions about watch-list drugs to discuss them with their clinician.

            Use caution in patients experiencing other types of pulmonary diseases (i.e. COPD)

            Syncope may occur with pulmonary arterial hypertension, particularly with physical exertion (adjust dose and reassess efficacy)

            Risk of syncope - monitor vital signs when initiating

            Use cautioin in patients with bleeding disorders

            Rebound hypertension may occur with dose reductions or withdrawals

            Administered only via the Prodose® AAD® System

            Not for use in patients with hypotension (systolic BP <85 mm Hg)

            Discontinue immediately if signs of pulmonary edema

            Bleeding events are most commonly reported as epistaxis or hemoptysis

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Excretion in milk unknown, low levels of drug or metabolite in milk have been observed; not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Synthetic analog of prostagladin PGI2, dilates systemic & pulmonary arterial beds; suppresses vascular smooth muscle proliferation and alters pulmonary vascular resistance when used long term

            Pharmacokinetics

            Vd: 0.7-0.8 L/kg

            Protein Bound: 60%

            Duration: 30-60 min

            Metabolism: Principally via beta-oxidation of carboxyl side-chain

            Metabolite: Tetranor-iloprost (inactive)

            Half-life: 20-30 min

            Peak serum time: Within 5 min (following inhalation)

            Excretion: Urine (68%); feces (12%)

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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