Iloprost Zentiva (Iloprost)

• Iloprost is a prostacyclin analog used in the management of pulmonary vascular disorders.
• Pulmonary arterial hypertension: improves hemodynamics and exercise capacity in affected patients.
• Digital ulcers associated with systemic sclerosis: promotes ulcer healing and reduces pain.

• Iloprost mimics endogenous prostacyclin (PGI2) and selectively activates the IP (prostacyclin) receptor on vascular smooth‑muscle cells. Receptor activation increases intracellular cyclic AMP, leading to potent vasodilation of pulmonary and systemic arteries and inhibition of platelet aggregation, thereby reducing pulmonary vascular resistance and improving tissue perfusion.

Iloprost may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Headache: mild to moderate intensity.
• Flushing: transient warmth and redness of the skin.
• Nausea or vomiting: gastrointestinal discomfort.
• Hypotension: drop in blood pressure, especially with rapid infusion.
• Jaw pain or toothache: often described as a dull ache.
• Cough or throat irritation: related to the intravenous route.

Serious or Rare Side Effects

• Pulmonary edema: accumulation of fluid in the lungs.
• Severe hypotension: marked blood‑pressure decline requiring intervention.
• Bleeding complications: due to platelet inhibition.
• Arrhythmias: abnormal heart rhythms.
• Thrombocytopenia: low platelet count.
• Anaphylactic reaction: rare but potentially life‑threatening hypersensitivity.

• When using Iloprost, clinicians should observe several safety measures.
• Monitor blood pressure: watch for hypotensive episodes during and after infusion.
• Assess bleeding risk: avoid use in patients with active hemorrhage or uncontrolled coagulopathy.
• Evaluate for pulmonary edema: discontinue if signs of fluid overload appear.
• Use caution in recent myocardial infarction: cardiac stress may be increased.
• Adjust in severe renal or hepatic impairment: consider reduced infusion rates.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Iloprost can interact with other medicines, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of bleeding.
• Other prostacyclin analogs (e.g., epoprostenol): additive vasodilatory effects leading to severe hypotension.
• Endothelin receptor antagonists combined with high‑dose iloprost: may cause excessive pulmonary vasodilation.

Moderate Interactions (Monitor Closely)

• Aspirin or NSAIDs: may enhance platelet inhibition.
• Phosphodiesterase‑5 inhibitors (e.g., sildenafil): potential additive vasodilatory effect.
• Beta‑blockers: may blunt compensatory heart‑rate response to hypotension.