Iloprost (Ventavis)

An inhalation solution indicated for the treatment of pulmonary arterial hypertension.

Improves exercise tolerance, symptoms and lack of deterioration in pulmonary arterial hypertension.

Iloprost, A medication used to treat pulmonary arterial hypertension, scleroderma, Raynaud’s phenomenon, Thromboangiitis obliterans, and other diseases in which the blood vessels are constricted and blood cannot flow to the tissues. 

Iloprost works by dilating the blood vessels to allow the blood to flow through.

Decreases vascular resistance by 32%, increases cardiac output by 20%, and decreases the mean arterial pressure by 9%.

Use may be associated with hypotension and may lead to syncope.

Use maybe associated with bronchospasm.

Iloprost is given via inhalation.

Iloprost is metabolized principally via β-oxidation of the carboxyl side chain. 

Elimination half-life 20–30 minutes.

Iloprost is a synthetic analogue of prostacyclin PGI2. 

It dilates systemic and pulmonary arterial vascular beds. 

It also affects platelet aggregation.

The approved dosing regimen for iloprost is 6 to 9 times daily.

The significant clinical effects are achieved with a median dose of 30 μg per day.

The first inhaled dose of iloprost should be 2.5 μg.

Iloprost is also available in an intravenous form.

It is usually administered diluted, via a peripheral vein or central venous catheter. 

The duration of the treatment is typically 3 days, and is usually repeated every 8 to 12 weeks.

May cause pulmonary venous hypertension and pulmonary edema may occur.


unstable angina; within 6 months of myocardial infarction; decompensated cardiac failure; severe arrhythmias; congenital or acquired heart-valve defects; within 3 months of cerebrovascular events; pulmonary veno-occlusive disease; conditions which increase risk of bleeding.

Common adverse reactions due to inhaled iloprost include: vasodilation (flushing, 27%), cough (39%), headache (30%), flu syndrome (14%), nausea (13%), neck spasms (12%), hypotension (11%), insomnia (8%), and fainting (syncope) (8%).

Serious adverse events: congestive heart failure, chest pain, supraventricular tachycardia, dyspnea,  nest pain, swelling of the ankles and feet, and kidney failure.

Vital signs are monitored while initiating inhaled iloprost therapy. 

Dose adjustments or a change in therapy should be considered if exertional syncope occurs. 

It should not be initiated in patients with systolic blood pressure lower than 85 mm Hg. 

It should be immediately discontinued if signs of pulmonary edema occur. 

Iloprost has not been evaluated in patients with chronic obstructive pulmonary disease (COPD), severe asthma, or with acute pulmonary infections.

Adverse events reported at a rate of less than 3% include CHF, chest pain, supraventricular tachycardia, dyspnea, peripheral edema, and renal insufficiency.

Vital signs should be monitored during the initiation of the drug.

Associated with flushing, cough, headache, tries us, insomnia, nausea, hypotension, heart palpatations.vomiting, elevation of alkaline phosphatase, flulike syndrome, tongue pain, back pain, palpitations, syncope, muscle cramps, hemoptysis, and pneumonia.

Can potentiate the hypotensive effects of vasodilators and  antihypertensive drugs, and has the potential to increase bleeding in patients on anticoagulants or platelet inhibitors.

Approved to treat frostbite when injected into tissues as it dilated blood vessels, and prevents clotting, decreasing the risk of needing fingers or toes to be amputated.

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