Iloprost

Class: Vasodilating Agents
VA Class: HS875
Chemical Name: (E)-(3aS,4R,5R,6aS)-hexahydro-5-hydroxy-4-[(E)-(3S,4RS)-3-hydroxy-4-methyl-1-octen-6-ynyl]-Δ2(1H),Δ-pentalenevaleric acid
Molecular Formula: C₂₂H₃₂O₄
CAS Number: 73873-87-7
Brands: Ventavis

Medically reviewed by Drugs.com on Jul 26, 2021. Written by ASHP.

Introduction

Vasodilator and platelet-aggregation inhibitor; a synthetic prostacyclin (PGI₂) analog.

Uses for Iloprost

Pulmonary Arterial Hypertension (PAH)

Management of PAH (WHO group 1 pulmonary hypertension) to improve a composite end point consisting of exercise tolerance, symptoms (NYHA/WHO functional class), and lack of clinical deterioration; has been designated an orphan drug by FDA for this use.

Efficacy established principally in patients with NYHA/WHO functional class III or IV PAH (idiopathic, heritable, or associated with connective tissue diseases).

Recommended as one of several treatment options for management of PAH in patients with NYHA/WHO functional class III or IV symptoms who are not candidates for calcium-channel blocker therapy or in whom such therapy failed.

Individualize choice of PAH therapy; consider factors such as disease severity, route of administration, potential adverse effects, costs of treatment, clinician experience, and patient preference.

In patients with inadequate response to initial monotherapy, may consider combination therapy with an endothelin-receptor antagonist, phosphodiesterase (PDE) type 5 inhibitor, or soluble guanylate cyclase stimulator (added sequentially). Such combination therapy may provide additive and/or synergistic benefits by targeting different pathophysiologic pathways of the disease.

Iloprost Dosage and Administration

General

Restricted Distribution

• Iloprost and nebulizers available only through specialty pharmacies. Contact manufacturer at 866-228-3546 for specific information.

Administration

Oral Inhalation

For oral inhalation only. Do not ingest orally.

Administer using the I-neb AAD system ultrasonic nebulizer.

Each treatment session generally lasts 4–10 minutes. May interrupt treatment session for ≤10 minutes with no effect on dose administered. If interruption exceeds 10 minutes, system resets itself and patient should discard remaining solution in the nebulizer drug chamber and wait ≥2 hours for the next dose.

Patients should have immediate access to a back-up system in the event of equipment malfunction.

Patients should be trained in proper administration (including dosing frequency), manipulation of glass iloprost ampuls, and nebulizer operation/maintenance.

Do not admix iloprost with other orally inhaled drugs. Do not use nebulizer to administer any other drugs.

Do not allow solution to come in contact with the eyes or skin.

I-neb AAD System

Commercially available in 1-mL single-use ampuls containing 10 or 20 mcg/mL of iloprost.

The 20-mcg/ mL concentration is intended for patients who are receivin..