What is Iloprost?
Iloprost is a medication that helps improve blood flow to the fingers and toes. It improves the circulation by opening up the small blood vessels allowing more blood to flow.
What is Iloprost used for?
Iloprost is used to treat Raynaud’s phenomenon that hasn’t responded to other medications.
Raynaud’s occurs because the blood vessels supplying the area are very sensitive to changes in temperature and temporarily constrict (close down) too much in the cold. Constriction of blood vessels is a normal response to the cold by the nerves in the fingers and toes to conserve heat. However in Raynaud’s this response is exaggerated.
When the blood vessels close up for a long period of time, the skin can form ulcers. Opening back up the blood vessels to these areas can help healing and prevent any further ulcers from forming.
Lung specialists who treat patients who have high blood pressure in the lungs called pulmonary artery hypertension also use Iloprost.
How is it given?
Iloprost is usually given through a drip into a vein in the arm. This is called an infusion. The dose of the medication in the drip is calculated based on your weight.
The infusion is given slowly and the dose increased in steps to ensure that you don’t develop side effects. Your blood pressure and observations are monitored throughout. The drip is given for around 6 hours a day and for a period of 3 days. This is usually given in the Rheumatology day unit, but can also be given in certain circumstances as an inpatient on a ward.
The effects are usually felt starting from the first infusion and can take up to several weeks to have the full effect which can last months.
Before your first dose, your bloods will be checked to make sure your blood counts, liver and kidney function are within range.
There are a few side effects than can occur when receiving the infusions; these usually disappear once the infusion dose has been reduced. They include:
- Feeling sick, vomiting
- Stomach pain and diarrhoea
- Feeling flushed and warm
- Low blood pressure
- This can give you headaches, dizziness and make you feel very tired. It can rarely cause fainting.
- Cough and shortness of breath
- Chest pain
- Liver abnormalities
- Increased risk of bleeding
Cautions for use
Interactions with other medications
- Iloprost can interact with other medications used to treat high blood pressure; these are usually stopped whilst you have the drips, or your iloprost dose can be reduced.
- Caution should be taken if you are on any medication that thins the blood or stops clotting such as aspirin.
Contraindications of other conditions
- If you have heart or breathing problems, your doctor will check whether iloprost is suitable for you.
- In liver and kidney disease, iloprost doses should be reduced or avoided.
- Iloprost can make you more prone to bleeding, so it should not be used if you have any history of bleeding stomach ulcers, trauma or bleeds in the brain.
- If you require surgery, this should not be delayed.
During pregnancy and breastfeeding
- Iloprost is not thought to be safe in pregnancy and breastfeeding.
- There are no known interactions, but it is advisable not to drink alcohol during the course of your 3 infusions as it can sometimes make the side effects worse.
- We recommend all our patients to keep within the recommended 14 units weekly.
- Iloprost is not known to interact with any vaccines.
Versus Arthritis: http://www.versusarthritis.org