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Epoprostenol (Injection)

Epoprostenol (e-poe-PROST-en-ol)

Treats symptoms of pulmonary hypertension, a lung disorder that increases blood pressure in the artery that carries blood from the heart to the lungs.

Brand Name(s):

Flolan, Veletri

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to epoprostenol, if you have severe heart failure, or if you develop pulmonary edema (a build-up of fluid in the lungs that causes severe shortness of breath and a heavy feeling in the chest).

How to Use This Medicine:

Injectable

  • Your doctor will prescribe your exact dose and tell you how often it should be given. Do not use more medicine than your doctor tells you to.
  • The medicine is given as an infusion through a catheter that is placed directly into a vein. The medicine must be given all the time, all day long.
  • Different brands of this medicine are available. Each brand must be prepared in a different way for different patients. The medicine is a powder that needs to be mixed with a liquid before it is given. Your health caregiver should show you how to mix your specific medicine for your specific treatment.
  • Epoprostenol must be given all the time through a portable pump. You can move around and walk while receiving the medicine.
  • You should be shown how to use the pump for the infusion. Make sure you understand all instructions. Ask your doctor, nurse, or home healthcare provider if you have any questions. You may also want a friend or someone in your family to also learn how to give your medicine.
  • You will be taught how to take care of the catheter. You need to keep it clean so you do not get an infection.
  • Mix the powder with only the liquid that your caregiver told you to use. Do not mix epoprostenol with other medicines.
    • Flolan®: The liquid should come in the package with the powder medicine.
    • Veletri®:Mix with sterile water for injection, USP, or sodium chloride 0.9% injection, USP.
  • Look at the medicine bag or bottle before your treatment. If you see any solid pieces or specks in the liquid or if it has changed color, do not use it.
  • Use only the supplies provided in the medication kit to inject Flolan®. The mixed medicine must be injected using the provided infusion tubing, because it has a filter that will remove any solid pieces or specks in the liquid.
  • Ask your doctor who to call if you have any problems with the infusion pump. You may be given a second infusion pump to have in case the first pump stops working. Make sure you have access to this pump as a backup at all times.
  • Use a new needle and syringe each time you inject your medicine.
  • You will need to continue using this medicine for a long period of time, possibly for many years. Talk with your doctor if you have any concerns about this.

If a dose is missed:

  • This medicine is given continuously. Do not stop your treatment unless your doctor tells you to. If you must stop your infusion, call your doctor or pharmacist for instructions first.

How to Store and Dispose of This Medicine:

  • Store the powder and sterile liquid in the original carton at room temperature. Keep the carton away from heat, moisture, and direct light.
  • Different brands of this medicine have different storage instructions. You must follow the instructions that came with your specific medicine.
  • Flolan®: After you mix the powder and the liquid, store this mixture in the refrigerator or in a cold pouch for up to 48 hours. Do not freeze. Throw away any mixture that has been refrigerated for more than 48 hours.
  • Veletri®: After you mix the powder with the liquid, store this mixture in the refrigerator for up to 8 days. Do not freeze. If you use the mixture right away, it does not need to be cold.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine, containers, and other supplies. You will also need to throw away old medicine after the expiration date has passed.
  • Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using digoxin (Lanoxin®), a diuretic (water pill, such as chlorthalidone, hydrochlorothiazide (HCTZ), furosemide, indapamide, spironolactone, torsemide, triamterene, Lasix®, Zaroxolyn®), blood pressure medicine (such as amlodipine, atenolol, clonidine, lisinopril, metoprolol, Benicar®, Cozaar®, Diovan®), or a blood thinner (such as warfarin, Coumadin®, Jantoven®).

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have other heart disease, lung disease, or bleeding problems.
  • You must keep the area around the catheter clean to prevent infection. Tell your doctor or health caregiver right away if you think you have an infection. Some symptoms are fever, chills, or changes to the skin area around the catheter, such as draining pus, bad smell, or redness and warmth.
  • Do not stop using this medicine suddenly or change your dose unless your doctor tells you to. Stopping or changing the dose could bring on symptoms of your condition and can be dangerous.
  • This medicine may lower your blood pressure, which can cause dizziness, lightheadedness, or fainting.
  • Your health caregiver will tell you how to take care of emergencies, such as your catheter getting damaged. Make sure you understand what to do if there is a problem.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Change in how much or how often you urinate
  • Chest pain
  • Extreme warmth or redness in the face, neck, arms, or upper chest
  • Fast, slow, or uneven heartbeat
  • Fever, chills, cough, sore throat, and body aches
  • Lightheadedness, dizziness, or fainting
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet
  • Severe redness, pain, rash, swelling, or a hard lump where the needle is placed
  • Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

  • Mild diarrhea, nausea, vomiting, loss of appetite
  • Feeling nervous or anxious, trembling
  • Headache
  • Jaw pain, muscle pain, stomach pain
  • Mild skin rash, itching, or sores
  • Warmth or redness in your face, neck, arms, or upper chest

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 4/4/2014

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