Iloprost

Synthetic analog of prostacyclin also known as prostaglandinI2 or PGI2.

• Intravenous therapy: Approved for the treatment of advanced thrombangiitis obliterans (Buerger's disease) with severe circulatory problems in cases where revascularization is not indicated.
• Off Label Use: Perniones; systemic scleroderma (especially digital ulcers); diabetic foot syndrome.
• Inhaled Therapy: Approved for primary pulmonary hypertension of functional severity NYHA III.

• Intravenous therapy:
• A fixed generally recommended dosage does not exist. The dosage administered per time unit must be determined individually and depends on the individual tolerance. It lies between 0.5 and 2.0 ng iloprost/kg bw/min. The individually tolerated dose is determined over 2-3 days.
• Initially infuse 0.5 ng/kg bw/min over 30 minutes (peripheral vein or central venous). Subsequently, dose escalation in approximately half-hourly intervals in steps of 0.5 ng/kg bw/min. to a maximum of 2.0 ng/kg bw/min. The exact maintenance dose based on body weight should be set to 0.5-2.0 ng/kg bw/min. The treatment duration is generally 4 weeks.
• A constant administration of the active ingredient is essential! Two different ready-to-use solutions can be prepared from one ampoule of Ilomedin 20 μg/ml:
• 0.2 μg/ml: may only be applied with an infusion tube pump (e.g. Infusomat).
• 2 μg/ml: may only be applied with an infusion syringe pump (perfusor).
• Inhalative therapy: 2.5 µg or 5.0 µg (dose released at the mouthpiece of the nebuliser). Initial 2,5 µg (first inhalation), followed by 5,0 µg (second inhalation). Application using a compressed air nebuliser system (e.g. HaloLite or ProDose).

• Intravenous use (Ilomedine):
• Very frequent: headache, nausea, drop in blood pressure, flush, vomiting, fever, sweating, pruritus, chills, fatigue, exhaustion, thirst, reactions at the injection site (erythema, pain, phlebitis).
• Frequent: anorexia, dizziness, paraesthesia, restlessness, myalgia or muscle pain.
• Inhalation (Ventavis): vasodilation, hypotension, headache, cough.

• Intravenous therapy: Risk of acute bleeding or bleeding complications (e.g. gastric ulcer, polytrauma, intracranial bleeding); severe coronary heart disease; unstable angina pectoris; myocardial infarction within the last 6 months; acute or chronic heart failure (NYHA II-IV); cardiac arrhythmia; suspected pulmonary congestion; hypersensitivity to the active substance or one of the other ingredients.
• Inhalative therapy: Decompensated heart failure if not under close medical supervision; severe arrhythmias; cerebrovascular events (e.g. TIA; apoplexy within the last 3 months); pulmonary hypertension due to pulmonary veno-occlusive disease; heart valve defects with clinically relevant myocardial dysfunction not associated with pulmonary hypertension.