Epoprostenol Sodium Lyophilized Injection

• Type: Vasodilator and platelet aggregation inhibitor

• Drug Class: Prostacyclin (Prostaglandin I₂ analog)

• Form: Lyophilized powder (freeze-dried) that must be reconstituted with sterile diluent for intravenous (IV) infusion

How It Works

• Epoprostenol is a synthetic form of prostacyclin, a natural substance produced by the blood vessel lining.

• It works by:

  • Relaxing smooth muscle in blood vessel walls → leads to vasodilation (especially in the lungs)

  • Inhibiting platelet aggregation, reducing the risk of clot formation

• The overall effect is lowering pulmonary artery pressure and improving blood flow in patients with pulmonary hypertension.

Common Uses

Epoprostenol is primarily used for:

• Pulmonary arterial hypertension (PAH) – to improve exercise capacity and symptoms

• Short-term use during cardiac surgery or dialysis to prevent platelet clumping (rare)

• Sometimes used in severe, life-threatening Raynaud’s phenomenon or digital ischemia (specialist use)

Advantages

• Considered a life-saving drug for advanced PAH

• Rapid onset of action after IV infusion

• Improves exercise tolerance, symptoms, and quality of life in PAH patients

• Reduces mortality risk when used long-term with proper monitoring

Possible Side Effects

Common:

• Headache

• Flushing

• Nausea, vomiting

• Jaw pain

• Diarrhea

Serious but Less Common:

• Low blood pressure (hypotension)

• Bleeding risk (due to platelet inhibition)

• Chest pain or palpitations

• Catheter-related infections (because it requires continuous IV infusion through a central line)

Precautions

• Must be given as a continuous IV infusion (usually via an infusion pump) – abrupt discontinuation can cause rebound pulmonary hypertension, which is life-threatening

• Monitor blood pressure, heart rate, and oxygen levels closely

• Dose must be titrated carefully under specialist supervision

• Requires strict aseptic technique during preparation to avoid bloodstream infections

• Not to be used in patients with severe left-sided heart failure or uncontrolled bleeding