AdultPediatricDosage Forms & Strengths single-use ampule 10mcg/mL (1mL) 20mcg/mL (1mL) Pulmonary Arterial Hypertension Initial: 2.5 mcg inhaled, if well-tolerated, THEN 5 mcg subsequent doses 6-9 times/day PRN; >q2hr while awake Maintenance: 2.5-5 mcg/dose; not to exceed 45 mcg/day Systemic Sclerosis (Orphan) Orphan designation for treatment of systemic sclerosis Orphan sponsor Eicos Sciences, Inc., a CiVi Biopharma, Inc. affiliated company; 200 Four Falls Corporate Center, Suite 107; West Conshohocken, Pennsylvania 19528 Safety and efficacy not establishedInteraction CheckerEnter a drug name and iloprostNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (1)lofexidinelofexidine, iloprost. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.Monitor Closely (17)aldesleukinaldesleukin increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.amifostineamifostine, iloprost. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.benazeprililoprost, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.captoprililoprost, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbidopacarbidopa increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.dabigatrandabigatran and iloprost both increase anticoagulation. Use Caution/Monitor. Both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.eluxadolineeluxadoline increases levels of iloprost by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered OATP1B1 substrates.epoprostenolepoprostenol, iloprost. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.fenoldopamfenoldopam, iloprost. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.fish oil triglyceridesfish oil triglycerides will increase the level or effect of iloprost by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.hydralazinehydralazine, iloprost. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.ibrutinibibrutinib will increase the level or effect of iloprost by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding. levodopalevodopa increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.minoxidililoprost, minoxidil. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.treprostinililoprost, treprostinil. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.warfariniloprost, warfarin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Drugs with antiplatelet properties may increase anticoagulation effect of warfarin.xipamidexipamide increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor.Minor (10)agrimonyagrimony increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.brimonidinebrimonidine increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.cornsilkcornsilk increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.forskolinforskolin increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.maitakemaitake increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).octacosanoloctacosanol increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.reishireishi increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.shepherd's purseshepherd's purse, iloprost. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.tizanidinetizanidine increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.treprostiniltreprostinil increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.agrimonyMinor (1)agrimony increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.aldesleukinMonitor Closely (1)aldesleukin increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.amifostineMonitor Closely (1)amifostine, iloprost. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.benazeprilMonitor Closely (1)iloprost, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.brimonidineMinor (1)brimonidine increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.captoprilMonitor Closely (1)iloprost, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbidopaMonitor Closely (1)carbidopa increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.cornsilkMinor (1)cornsilk increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.dabigatranMonitor Closely (1)dabigatran and iloprost both increase anticoagulation. Use Caution/Monitor. Both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.eluxadolineMonitor Closely (1)eluxadoline increases levels of iloprost by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered OATP1B1 substrates.epoprostenolMonitor Closely (1)epoprostenol, iloprost. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.fenoldopamMonitor Closely (1)fenoldopam, iloprost. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.fish oil triglyceridesMonitor Closely (1)fish oil triglycerides will increase the level or effect of iloprost by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.forskolinMinor (1)forskolin increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.hydralazineMonitor Closely (1)hydralazine, iloprost. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.ibrutinibMonitor Closely (1)ibrutinib will increase the level or effect of iloprost by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding. levodopaMonitor Closely (1)levodopa increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.lofexidineSerious - Use Alternative (1)lofexidine, iloprost. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.maitakeMinor (1)maitake increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).minoxidilMonitor Closely (1)iloprost, minoxidil. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.octacosanolMinor (1)octacosanol increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.reishiMinor (1)reishi increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.shepherd's purseMinor (1)shepherd's purse, iloprost. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.tizanidineMinor (1)tizanidine increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.treprostinilMonitor Closely (1)iloprost, treprostinil. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.Minor (1)treprostinil increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.warfarinMonitor Closely (1)iloprost, warfarin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Drugs with antiplatelet properties may increase anticoagulation effect of warfarin.xipamideMonitor Closely (1)xipamide increases effects of iloprost by pharmacodynamic synergism. Use Caution/Monitor. >10% Flushing (18%) Cough (39%) Hypotension (11%) Nausea (13%) Headache (30%) Jaw pain (12%) Trismus (12%) 1-10% Palpitations (7%) Syncope (8%) Insomnia (8%) Vomiting (7%) Tongue pain (4%) Back pain (7%) Muscle cramps (6%) GGT elevated (6%) Hemoptysis (5%) Pneumonia (4%) <1% Kidney failure Bronchospasm Hypersensitivity Supraventricular tachycardia Contraindications None well documented Cautions Iloprost has been listed by the FDA as one of the drugs to monitor after having identified potential signs of serious risks or new safety information in the agency's Adverse Event Reporting System (AERS) database during the last 3 months of 2011. Hemoptysis has been reported with iloprost use. The FDA said that it is not suggesting that clinicians should stop prescribing any drugs on the watch list, or that patients should stop taking them. It advises patients with questions about watch-list drugs to discuss them with their clinician. Use caution in patients experiencing other types of pulmonary diseases (i.e. COPD) Syncope may occur with pulmonary arterial hypertension, particularly with physical exertion (adjust dose and reassess efficacy) Risk of syncope - monitor vital signs when initiating Use cautioin in patients with bleeding disorders Rebound hypertension may occur with dose reductions or withdrawals Administered only via the Prodose® AAD® System Not for use in patients with hypotension (systolic BP <85 mm Hg) Discontinue immediately if signs of pulmonary edema Bleeding events are most commonly reported as epistaxis or hemoptysis Pregnancy Limited published data from case series and case reports in pregnant women have not identified drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; there are risks to mother and fetus associated with pulmonary arterial hypertension Pulmonary arterial hypertension in pregnancy increases risk for maternal heart failure, stroke and death, miscarriage, preterm delivery, low birthweight infants, and stillbirth Animal data In animal reproductive studies, administration of continuous intravenous therapy to pregnant Han-Wistar rats during organogenesis at doses 2-times recommended human dose on a mg/m2 basis resulted in adverse developmental outcomes However, there were no adverse developmental outcomes with intravenous administration of iloprost to pregnant Sprague- Dawley rats, rabbits and monkeys at doses 1200-, 180-, and 14-times, respectively, the recommended human dose on a mg/m2 basis Lactation There are no data on presence of iloprost in human milk, effects on breastfed infant, or on milk production; drug is present in rat milk; when drug present in animal milk, it is likely drug will be present in human milk Because of potential for serious adverse reactions, advise women not to breastfeed during treatmentPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Synthetic analog of prostagladin PGI2, dilates systemic & pulmonary arterial beds; suppresses vascular smooth muscle proliferation and alters pulmonary vascular resistance when used long term Pharmacokinetics Vd: 0.7-0.8 L/kg Protein Bound: 60% Duration: 30-60 min Metabolism: Principally via beta-oxidation of carboxyl side-chain Metabolite: Tetranor-iloprost (inactive) Half-life: 20-30 min Peak serum time: Within 5 min (following inhalation) Excretion: Urine (68%); feces (12%) No images available for this drug. No images available for this drug.Print Patient Educationiloprost inhalation ILOPROST SOLUTION - INHALATION (EYE-loe-prost) COMMON BRAND NAME(S): Ventavis USES: This medication is used to treat a type of high blood pressure in the lungs (pulmonary arterial hypertension). Iloprost helps to increase your ability to exercise and improves symptoms such as shortness of breath and tiredness. It works by relaxing and widening the blood vessels (arteries) in the lungs and other parts of the body so that blood can flow more easily. This medication belongs to a class of drugs known as vasodilators. HOW TO USE: Read the Patient Information Leaflet available from your pharmacist. This medication comes in a glass bottle (ampule). Follow the manufacturer's instructions on how to open the ampule and how to prepare each dose. This product is used with a special breathing device (nebulizer). Ask your doctor, pharmacist or respiratory therapist how to inhale this medication properly with this equipment. Make sure you understand how to properly clean the nebulizer to prevent infections.Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Do not mix with other medications in the nebulizer.Inhale this medication by mouth as directed by your doctor, usually 6 to 9 times daily, at least 2 hours apart. Do not drink the solution. Do not get this medication on the skin or in your eyes. If this happens, rinse the area with water. The dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.To avoid not being able to use your medication, be sure to have