Iloprost (Inhalation)

Introduction

Iloprost inhalation is used in the treatment of symptoms of pulmonary arterial hypertension. This is high blood pressure that happens in the main artery that carries blood from the right side of the heart straight to the lungs. When you experience high blood pressure, the blood vessels in the lungs have smaller openings and become tighter. This means that right ventricle must work harder to pump the required amount of blood to and around the lungs. This is a man-made hormone called prostacyclin. Prostacyclin is produced in the lungs and works by keeping the blood vessels relaxed. People who suffer from pulmonary arterial hypertension don't make enough prostacyclin in the lungs. Iloprost will allow the blood vessels to relax, which will increase the supply of blood to the lungs thus helping to reduce the heart's workload. You can only obtain this medication via a prescription from your doctor and it is available in the dosage form of a solution.

Conditions treated

  • Pulmonary Arterial Hypertension

Type of medicine

  • Solution

Side effects

Along with the intended effects of this drug, it can produce unwanted side effects. Not all of these side effects may occur at once, but if they do, you may need to seek medical attention.

Seek advice from a healthcare professional or your doctor immediately if you suffer from any of the following side effects whilst taking this drug.

Incidence not known

  • Itching

Some of the side effects that occur with this drug don't usually require medical attention. You usually find that these side effects are not severe and disappear as your body begins to adjust to the medication. However, if you are finding them bothersome, you can contact your local healthcare professional or doctor for advice on ways to reduce or prevent the severity of these side effects. Consult with your health care professional if any of the following side effects become persistent or cause annoyance.

More common

  • Feeling of warmth

Less common

  • Change in taste

Incidence not known

  • Stuffy nose

You may suffer from other side effects that are not listed above. If you notice anything unusual, then contact your doctor or healthcare professional.

Dosage

The final dose of this medication will be dependent upon a number of personal factors and specifics of the medication in question. Your doctor will take a variety of factors into account including, your weight, age and height, any other medical conditions you suffer from and any corresponding medication you take to treat them. They will also consider what specific condition you are being treated for, the strength of the medication, the duration of the treatment and your reaction to the first dose. Do not take more of this medication than prescribed by your doctor. To do so, could increase your risk of side effects. Alternatively, if you take too little of this medication, it may not work as it should do and reduce its effectiveness.

For inhalation dosage form (solution) for pulmonary arterial hypertension:

Adults: Initially take 2.5 micrograms six to nine times daily whilst awake. Don't use more than once every two hours. Your doctor may adjust your dose if necessary. However, typically the dose is no more than 45 mcg each day.

Children: the dose and use will be determined by your doctor.

Missed Dose

If you miss a dose of this medication, you need to take it as soon as you've remembered. This is unless it's almost time for your next dose. In this instance, you should skip the missed dose and revert back to the original schedule. Don't double your doses to make up for a missed dose.

Proper use

Iloprost inhalation solution is taken via breathing in through the mouth and into the lungs. You should use it when you wake up and before you perform or engage in any physical activity. However do not use it more than once every two hours.

The iloprost inhalation solution is used alongside a nebulizer that is attached to an air compressor. This nebulizer will create a mist that you breathe into the lungs via a mouthpiece. This solution should only be used with the I-neb® AAD® System. The nebulizer and solution will come with patient instructions. You should read and follow these carefully and seek advice if you don't understand something. Don't mix the iloprost solution with other medications in the nebulizer.

To make sure you don't miss a dose, you should always keep an extra nebulizer on hand.

Don't drink this medication and don't allow the solution to come in contact with your eyes or skin. If it does, use water to rinse it off immediately.

Interactions

This drug can interact with a number of other medications. These interactions could cause severe side effects and reduce the effectiveness of either drug in its treatment. When possible your doctor will avoid treating you with this drug, but in some cases interactions are unavoidable. To help limit the risk of such interactions, it's important that you give your healthcare professional or doctor a complete list of all the current and past medications that you are currently taking. You should also make them aware of other health conditions you may suffer from.

The use of this medication alongside any of the following is not recommended. Your doctor may avoid treating you with this drug altogether or alter some of the other medications you are currently taking.

  • Defibrotide

The use of this medication alongside any of the following drugs is not typically recommended, but in some cases, it may be necessary. If you are prescribed both medications at once, your doctor may alter the dose or frequency you use either medication.

  • Apixaban
  • Niflumic Acid
  • Ketorolac

Let your doctor know if you are taking any of the following medications. These drugs used in conjunction could provide moderate interactions.

  • Metoprolol

Other medical conditions

The presence of other medical conditions can increase your risk of interactions or reduce the effectiveness of this medication. It's important to make your doctor aware of any other medical conditions you may suffer from including:

  • Hypotension (low blood pressure): this drug should not be used in those who suffer from this condition.

Warnings

Before you commit to taking a medication, there are a number of factors and precautions you should consider first.

Allergies

It's important to let your doctor or healthcare professional know if you have ever suffered from an allergic reaction to this medication or any other medications. You should also make them aware of any other allergies you may suffer from such as to animals, preservatives, dye, and foods.

Pediatric population

Appropriate studies have not been conducted on the relationship of age to the effects of this drug in the pediatric population. Therefore efficacy and safety have not yet been established.

Geriatric population

Appropriate studies conducted to date have not indicated a geriatric-specific problem that could limit the usefulness of iloprost inhalation in the older population. However, elderly patients are more likely to have age-related kidney, liver, or heart conditions, which could require an adjustment in dose and a degree of caution to be exercised.

Use in pregnancy and breastfeeding

This drug is under FDA pregnancy category C. It's unknown whether iloprost can harm an unborn child. You should make your doctor aware if you are currently pregnant or intend to become pregnant whilst taking this medication.

It's unknown whether this drug can pass into breast milk or if it could cause harm to a nursing infant. You should avoid breastfeeding while you are using iloprost.

It's extremely important that your doctor monitors your progress at regular checkups to ensure the medication is working correctly.

This medication can cause your blood pressure to go down. Your doctor will monitor your blood pressure before you start the medication and test it during your appointments. You may need to also monitor your blood pressure at home. Call your doctor immediately if you notice any changes in your recommended blood pressure.

Dizziness, fainting or lightheadedness can occur after you use this medication, especially when you get up suddenly from a sitting or lying position. You should get up slowly to help but if your problem becomes worse, seek attention. Ensure that you know how your body will react to this medication before you use machinery, drive, or do anything else that could be dangerous if you are lightheaded or dizzy.

Stop using this medication and check with your doctor immediately if you experience any of the following symptoms:

  • Swelling of the ankles or legs
  • Increased sweating
  • Blue lips and fingernails

These could be signs of fluid in the lungs (pulmonary edema)

Storage

This medication should be stored in a closed container at room temperature. You should keep it away from moisture, heat, and light, Make sure you prevent this medication from freezing. Keep this drug out of the reach of children. Do not keep medication that has expired or you no longer need. You should ask your local pharmacist for advice on the proper way to dispose of medication you no longer need.

Summary

When used as directed, this drug is successful in the treatment of pulmonary arterial hypertension. Due to a large number of interactions possible, it's important that you inform your doctor of all medications you are taking this medication. This safety and efficacy of this drug have not been established in children. You should take this medication only as been directed as by your doctor and do not change your doses without consultation. You should let your doctor know if you are pregnant or intend on becoming pregnant and you should avoid breastfeeding whilst taking this medication. If you require any further information about the practical uses of this medication, or you have any further questions, you should contact your doctor or local healthcare professional for advice. Let your doctor or healthcare professional know if your condition worsens or doesn't improve.