Iloprost

What the treatment is and why it's prescribed

Iloprost is a prostaglandin, a medicine used to treat high blood pressure (hypertension) and other diseases where blood vessels are constricted. Prostaglandins work by relaxing your artery wall muscles. This widens your arteries and reduces your blood pressure.

Iloprost is a man-made form of a substance called prostacyclin which is produced naturally in the body and improves blood flow in people with severe circulatory problems by reducing clumping of the red cells in the blood, which reduces the tendency of the blood to clot helping to prevent or repair damage to blood vessels.

How to take it and how long it takes to work

Iloprost usually starts to work immediately, although it can sometimes take up to six weeks.

If you've been suffering with very cold hands or feet they may feel warmer straight away. Ulcers may begin to improve within a few days.

Iloprost's beneficial effects may carry on for weeks and sometimes even months after the infusion. Usually, iloprost is prescribed if other drugs such as nifedipine haven't worked for you. Your doctor will discuss other treatment options with you if need be.

Iloprost is given through a drip (infusion) into your arm, usually continuously for about six hours a day for 3–5 days in a row in hospital or a clinic. It can sometimes be given continuously over 24 hours. You can also take it via a nebuliser.

The infusion will be started at a low dose and then increased gradually to make sure you can tolerate the higher doses. If you develop side-effects, your dose will generally be reduced again.

The rate at which iloprost is given depends on your weight, but can also be adjusted if you have side-effects.

Before taking treatment

You will need to stay in hospital for up to three days for treatment and to monitor your response. After this, you should be able to return home and continue taking the medicine.

How long you need to take iloprost for will depend on your condition. You may need to continue taking it, possibly alongside other treatments, until your condition worsens and you need epoprostenol.

Iloprost may not be suitable if:

• you have a peptic ulcer
• you have recently had a heart attack or stroke
• your pulmonary hypertension is caused by pulmonary veno-occlusive disease (a rare condition that causes high blood pressure in the lungs)
• your pulmonary hypertension is unstable, with advanced right heart failure

Information sourced from the NHS, Mayo Clinic and Arthritis Research UK.