Ilomedin (Iloprost Trometamol)

Ilomedin, a prostacyclin analog, is used to manage diseases characterized by vascular constriction and platelet activation.

• Pulmonary arterial hypertension: improves exercise capacity and reduces pulmonary vascular resistance.
• Digital ulcers associated with systemic sclerosis: promotes ulcer healing and reduces new ulcer formation.
• Peripheral vasospasm: alleviates vasospastic episodes and improves peripheral blood flow.

• Ilomedin contains iloprost trometamol, a synthetic analogue of prostacyclin (PGI2). It binds to prostacyclin (IP) receptors on vascular smooth‑muscle cells, activating adenylate cyclase and raising intracellular cyclic AMP. Elevated cAMP leads to relaxation of pulmonary and systemic arteries and inhibits platelet aggregation, thereby reducing vascular resistance and improving blood flow in affected tissues. The effect is dose‑dependent and reversible, providing controlled vasodilation during infusion.

Ilomedin may be associated with several adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Flushing: warm sensation and redness of the skin.
• Headache: mild to moderate intensity.
• Nausea: occasional gastrointestinal upset.
• Jaw pain: discomfort in the mandibular area.

Serious or Rare Side Effects

• Hypotension: significant drop in blood pressure requiring medical intervention.
• Pulmonary edema: accumulation of fluid in the lungs.
• Severe bleeding: uncontrolled hemorrhage due to platelet inhibition.

Before initiating Ilomedin therapy, several precautions should be considered to ensure patient safety.

• Contraindication: avoid use in patients with known hypersensitivity to iloprost or any component of the formulation.
• Cardiovascular monitoring: observe blood pressure and heart rate during infusion, especially in patients with existing hypotension.
• Bleeding risk: assess for active bleeding or anticoagulant therapy, as iloprost can impair platelet function.
• Pregnancy and lactation: use only if potential benefit justifies potential risk; discuss with a specialist.
• Renal impairment: adjust monitoring in patients with severe renal dysfunction due to altered drug clearance.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Ilomedin can interact with other medicines, influencing its efficacy or safety profile.

Major Interactions (Avoid)

• Phosphodiesterase‑5 inhibitors (e.g., sildenafil): combined use may cause severe hypotension.
• Endothelin receptor antagonists (e.g., bosentan): additive vasodilatory effect increasing risk of low blood pressure.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin, heparin): enhanced antiplatelet effect may increase bleeding risk.
• Calcium channel blockers (e.g., amlodipine): may potentiate vasodilation.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may affect renal function and blood pressure control.