Iloprost

Iloprost is known as a prostaglandin. It acts by imitating a naturally occurring substance in the body called prostacyclin. It is prescribed at GOSH to treat pulmonary hypertension (high blood pressure in the blood vessels in the lungs). It works by lowering blood pressure by widening the blood vessels in the lungs.The use of iloprost in children is not currently licensed in the UK. Medicines are often used outside of their license (off-label) in children because trial data is not available for a specific use. Prescribing medicines ‘off label’ is not necessarily hazardous but should be explained and agreed before use.

Iloprost is available as a 10microgram/ml solution which should be administered via a specific nebuliser called an i-Neb®. The nebuliser changes the solution into a mist which is then inhaled.

Breathing in the mist carries the iloprost directly to the blood vessels in the lungs making them widen. Your doctor, nurse or pharmacist will have explained to you how to give the dose before you leave hospital. When using the nebuliser, always make sure the room is well ventilated and that only a mouthpiece is used rather than a mask.

People with the following conditions should discuss taking iloprost with their doctor:

• Hypersensitivity to iloprost or any of its ingredients
• Bleeding disorders
• Recent history of stroke or heart attack
• Pregnancy, possibility of pregnancy, trying to become pregnant or breastfeeding

If any of these side effects are severe or persist for a long time, please tell the Pulmonary Hypertension team:

• Headache
• Dizziness or light-headedness (this may be helped by getting up slowly after sitting or lying down)
• Flushing
• Cough
• Tongue pain or throat irritation
• Wheeze

If any of the following side effects occur, please contact the Pulmonary Hypertension team for advice:Some people develop an allergic reaction to iloprost, which may be mild or severe. Signs of a mild reaction include skin rashes and itching, high temperature, shivering, redness of the face, a feeling of dizziness or a headache. If you see any of these signs please report them to a doctor or nurse.

• Chest discomfort
• Muscle or jaw pain
• Coughing of blood or blood stained sputum
• Unexplained or prolonged episodes of bleeding

Signs of a severe allergic reaction include any of the above, as well as shortness of breath or chest pain. If you are in hospital and your child shows signs of a severe allergic reaction, call a doctor or nurse immediately. If you are at home, call an ambulance immediately. If your child has a severe reaction to iloprost, subsequent treatment will be changed.

Some medicines can interact with iloprost and may alter its effects. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines.

Iloprost should not be taken with the following medicines except upon the advice of your doctor:

• Antihypertensives (blood pressure medicine)
• Anticoagulants and antiplatelets (blood thinning medicine)
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen