Epoprostenol (Injection)

Introduction

Epoprostenol (e-poe-PROST-en-ol)

Treats symptoms of pulmonary hypertension, a lung disorder that increases blood pressure in the main artery that carries blood from the heart to the lungs.

Brand Name(s)

There may be other brand names for this medicine.

Veletri, Flolan

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to epoprostenol, if you have severe heart failure, or if you develop pulmonary edema (a build-up of fluid in the lungs that causes severe shortness of breath and a heavy feeling in the chest).

How to Use This Medicine

Injectable

  • Your doctor will prescribe your exact dose and tell you how often it should be given. A nurse or other trained health professional will teach you or a caregiver how to give this medicine. The medicine is given as an infusion through a catheter that is placed directly into a vein. Do not use more medicine than your doctor tells you to.
  • Your doctor or nurse will teach you how to prepare the medicine and how to use the pump for the infusion. Epoprostenol must be given continuously by a portable pump. The tube that goes into your chest is called a central venous catheter. A small pump keeps the medicine going into your body. The pump is portable, so you can move or walk while getting the medicine.
  • You will be taught how to take care of the catheter and how to use the medicine and pump. It is important that you understand how to use the medicine and equipment correctly. If you have any questions, ask your doctor, nurse, or other health care provider.
  • You may also want a friend or someone in your family to learn how to give your medicine.
  • The medicine is a powder that needs to be mixed with a sterile (germ-free) liquid before it is given. You should not use any other liquid with the powder or mix epoprostenol with other medicines.
  • Look at the medicine bag or bottle before your treatment. If you see any solid pieces or specks in the liquid or if it has changed color, you should not use it for your treatment.
  • If you have your treatments at home, you should use a special container for used needles or tubes. Keep it where children or pets cannot reach it.
  • During use, the mixed solution can be administered by the pump at room temperature for up to 24 hours if you mixed the entire vial with the 5 milliliter solution provided. If you are using a lower concentration, the mixture is only good for 12 hours. Protect the solution from direct sunlight.
  • Ask your doctor who to call if you have any problems with the infusion pump. You may be given a second infusion pump to have in case the first pump stops working. Make sure you have access to this pump as a backup at all times.
  • Use a new needle and syringe each time you inject your medicine.
  • You will need to continue using this medicine for a long period of time, possibly for many years. Talk with your doctor if you have any concerns about this.

If a dose is missed:

  • This medicine is given continuously. Do not stop your treatment unless your doctor tells you to. If you must stop your infusion, call your doctor or pharmacist for instructions first.

How to Store and Dispose of This Medicine

  • Store the powder and sterile liquid in the original carton at room temperature. Keep the carton away from heat, moisture, and direct light.
  • Store the mixed solution in the refrigerator for 5 days, away from direct light. Keep the medicine from freezing. Any medicine that has been frozen should be thrown away. Mixed solutions can be stored at room temperature (up to 25 degrees C) for no more than 48 hours. Discard the mixed solution if it is kept in the refrigerator for more than 5 days or at room temperature for more than 48 hours.
  • Look at the liquid in the vial. If the liquid has particles or specks in it or if the liquid has changed color, do not use the vial.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine, containers, and other supplies. You will also need to throw away old medicine after the expiration date has passed.
  • Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using digoxin (Lanoxin®), a diuretic or "water pill" (such as furosemide, hydrochlorothiazide [HCTZ], indapamide, metolazone, spironolactone, torsemide, triamterene, Aldactone®, Demadex®, Lasix®, Lozol®, Maxzide®, or Zaroxolyn®), blood pressure medicines (such as atenolol, lisinopril, metoprolol, quinapril, Accupril®, Cozaar®, Diovan®, Lotrel®, Norvasc®, Toprol®, or Zestril®), or a blood thinner (such as warfarin, Coumadin®).

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have heart disease, lung disease, or any signs of infection.
  • To prevent infection, you must keep the area around the catheter clean. If you have a fever or chills, or if the skin area around the catheter smells bad or is red, hot, or draining pus, tell your doctor or home health care provider.
  • Your health caregiver will tell you how to take care of emergencies such as air getting into your bloodstream through your catheter or if your catheter gets torn or damaged. Make sure you know what to do if these problems occur.
  • This medicine may cause your blood pressure to decrease, which can cause dizziness, lightheadedness, or fainting.
  • Do not suddenly stop using this medicine. Stopping or changing the dose of this medicine suddenly may bring on symptoms of your condition and can be dangerous. Check with your doctor before stopping or changing your dose.
  • Your doctor may want you to carry a medical identification card stating that you are using this medicine.
  • Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
  • Change in how much or how often you urinate.
  • Chest pain.
  • Convulsions (seizures).
  • Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
  • Extreme warmth or redness in the face, neck, arms, or upper chest.
  • Fast, slow, or uneven heartbeat.
  • Fever, chills, cough, sore throat, and body aches.
  • Lightheadedness or fainting.
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
  • Severe redness, pain, rash, swelling, or a hard lump where the needle is placed.
  • Swelling in your hands, ankles, or feet.
  • Unusual bleeding, bruising, or weakness.
  • Wheezing or troubled breathing.

If you notice these less serious side effects, talk with your doctor:

  • Blurred vision.
  • Diarrhea.
  • Feeling nervous or anxious.
  • Headache.
  • Jaw pain, muscle pain, or stomach pain.
  • Skin rash, itching, or sores.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Review Date: 2011-02-04 Reviewed By: Keywords: ,
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