Epoprostenol
Epoprostenol is a prostacyclin analog used for rapid ↓ PVR in severe PAH.
Indications
Long-term treatment of pulmonary vasodilation for:
- Rapid reduction in pulmonary arterial pressures
- WHO functional class III/IV patients with:
- Idiopathic PAH
- Familial PAH
- Scleroderma spectrum disease with associated PAH
Contraindications
Principles
Epoprostenol:
- Has two major pharmacological actions:
- Direct vasodilation of pulmonary and systemic vasculature
- Inhibition of platelet aggregation
- Has a short half-life (2-6 minutes), and requires administration via continual infusion
Practice
Intravenous administration:
- Initiate at 2ng/kg/min
- Up-titrate by 1-2ng/kg/min every 15 minutes until
- No further response seen
- Dose limiting side effects reached:
- Hypotension
- Nausea
- Vomiting
- Headache
- 20-40ng/kg/min reached