Iloprost Teva (Iloprost)

• Iloprost is indicated for several vascular conditions where prostacyclin pathways are compromised.
• Pulmonary arterial hypertension: reduces pulmonary arterial pressure, improves functional class, and increases six‑minute walk distance in affected adults.
• Digital ulcers associated with systemic sclerosis: accelerates ulcer closure, decreases pain, and lowers the incidence of new digital lesions.
• Peripheral arterial disease: mitigates ischemic pain during walking, improves walking distance, and supports tissue perfusion in patients with limb ischemia.

• Iloprost is a synthetic analogue of prostacyclin (PGI2) that binds to prostacyclin (IP) receptors on vascular smooth‑muscle cells. Activation of the IP receptor stimulates adenylate cyclase, raising intracellular cyclic‑AMP levels, which leads to vasodilation, inhibition of platelet aggregation, and antiproliferative effects on the vascular wall, thereby improving blood flow in the pulmonary and peripheral circulations. These actions collectively reduce pulmonary vascular resistance and support microvascular repair.

Iloprost may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Headache: mild to moderate intensity, often transient.
• Flushing: warmth and reddening of the skin.
• Nausea: occasional gastrointestinal discomfort.
• Jaw pain: mild discomfort during infusion.
• Diarrhea: loose stools during treatment.
• Peripheral edema: swelling of the limbs.

Serious or Rare Side Effects

• Hypotension: significant drop in blood pressure requiring medical intervention.
• Bleeding: increased risk of hemorrhage due to platelet inhibition.
• Pulmonary edema: fluid accumulation in the lungs, a rare but serious event.

When prescribing Iloprost, clinicians should observe several precautionary measures to ensure patient safety.

• Dose titration: start with low dose and increase gradually under medical supervision.
• Cardiovascular monitoring: regularly assess blood pressure and heart rate during therapy.
• Bleeding risk: evaluate coagulation status and avoid concomitant anticoagulants unless necessary.
• Renal impairment: adjust therapy in patients with severe kidney dysfunction.
• Pregnancy and lactation: avoid use unless benefits outweigh potential risks.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

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

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin, heparin): additive antiplatelet effect may increase bleeding risk.
• Phosphodiesterase‑5 inhibitors (e.g., sildenafil): may cause profound hypotension.
• Endothelin receptor antagonists (e.g., bosentan): potential for enhanced vasodilatory response.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may affect renal function and platelet activity.
• Calcium channel blockers: possible additive blood pressure lowering effect.
• Beta‑blockers: may mask tachycardia associated with hypotension.