Iloprost for pulmonary arterial hypertension

About iloprost

Pulmonary arterial hypertension (PAH) is a condition where there is too high a blood pressure in the blood vessels which supply blood to your lungs from your heart. The arteries become narrowed so your heart has to work harder to pump blood to your lungs.

Iloprost works by mimicking the action of a natural substance in your body, called prostacyclin. Prostacyclin relaxes the muscles in the walls of some blood vessels, allowing blood vessels to become wider (dilated). This reduces the pressure in the blood vessels and allows blood to flow more easily through them. In turn, this increases the supply of blood to your lungs and improves your ability to do physical activities. Iloprost will be prescribed for you by a doctor who is a specialist.

Before using iloprost

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using iloprost it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have any problems with the way your liver works.

• If you have a heart condition such as a heart valve defect, or angina pain, or if you have recently had a heart attack.

• If you have any problems with your breathing such as if you have asthma or chronic obstructive pulmonary disease (COPD), or if you think you may have a chest infection.

• If you have recently had a stroke or a transient ischaemic attack (sometimes called a 'mini-stroke').

• If you think you may be at risk of bleeding, such as if you have recently had an injury or if you have a stomach ulcer.

• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine.

How to use iloprost

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack, along with any information you have been given by your hospital. The pack leaflet will give you more information about iloprost and how you should administer it. It will also provide you with a full list of the side-effects which you may experience from using it.

• Iloprost will be started for you in hospital and you will be shown what to do. You will be shown how to inhale the solution, using a nebuliser, which is a machine that turns the solution into a fine mist so that you can breathe it into your lungs.

• Once you are home, continue to use the solution in the nebuliser exactly as you have been shown. Your doctor will tell you how much solution to use for each dose and how many times a day to use the nebuliser. You will also be told how long each inhalation session should last. Most people will have 6-9 inhalation sessions spread throughout the day, with each session lasting about 4-10 minutes, depending upon the type of nebuliser used.

• You will be shown how to use a mouthpiece to inhale the mist, as this will help prevent any solution coming into contact with your face. Try not to let iloprost solution come into contact with other areas of your skin or your eyes. If this does happen, wash the area with water as soon as possible.

• Whenever you are using the nebuliser, please make sure that the area where you are is well ventilated and that there are no young children or pregnant ladies who could inhale the vapour in the room with you.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

• Treatment with iloprost is usually long-term unless you experience an adverse effect. Continue to use iloprost unless you are advised otherwise.

• If you buy any medicines 'over the counter', always check with a pharmacist that they are suitable for you to take. This is because some anti-inflammatory painkillers (such as aspirin) can increase the risk of unwanted bleeding.

• Women with pulmonary hypertension should avoid becoming pregnant as pregnancy can lead to serious worsening of your condition. Women of childbearing potential must use effective contraception during treatment with iloprost. Speak with your doctor about which contraceptive methods are suitable for you.

• If you are due to have an operation or some other medical treatment, it is important you tell the person carrying out the treatment that you are on iloprost.

Can iloprost cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with iloprost. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to the medicine, please speak with your doctor or pharmacist for further advice.

How to store iloprost

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.
  

Important information about all medicines