Parenteral Manual

Alprostadil

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
PGE1, PROSTIN® VR, PROSTAGLANDIN E1
Classification: 
Vasodilator
Original Date: 
August 2005
Revised Date: 
September 2011
Indications: 
  • Maintenance of the patency of ductus arteriosus in neonates until surgery can be performed
  • Pulmonary hypertension in infants/children with congenital heart defects with left-to-right shunts
Reconstitution and Stability: 
  • Available as a 500 mcg/mL solution
  • Store in fridge
  • Diluted solution stable 24 hours at room temperature.

 

Compatibility: 

- Solutions Compatible:  D5W, D10W, NS

- Additives/Above Cassette Compatible: caffeine

- Y-site Compatible: atropine, clindamycin, dexamethasone, digoxin, diphenhydramine, dopamine, epinephrine, furosemide, gentamicin, heparin, hydrocortisone, lidocaine, midazolam, morphine, pancuronium, phenobarbital, KCl (20 mmol/L), ranitidine

- Incompatible: levofloxacin

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion NO
IV Continuous Infusion

YES, into large vein or through an umbilical artery catheter placed at the ductal opening
Standard Concentration in ER/OR/PICU: 10 mcg/mL

Click here to access SDC Drug Infusion Sheet

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Neonates and Infants:

                 Initial:  0.05-0.1 mcg/kg/minute
                         - with therapeutic response, reduce rate to lowest effective dosage
                         - with unsatisfactory response, increase rate gradually

                Maintenance:  0.01-0.4 mcg/kg/minute

Potential hazards of parenteral administration: 
  • Apnea:  (10-12% of neonates), fever, flushing (with rapid rates of administration)
  • Hypotension, brady/tachycardia
  • Seizures
  • Hypoglycemia, hypocalcemia, hypo/hyperkalemia
  • Thrombocytopenia
  • Gastric-outlet obstruction with prolonged infusions (> 120 hours)
  • Extravasation may cause tissue sloughing and necrosis
Notes: 
  • Use only if facilities for intubation and ventilation are available
  • Monitor RR, HR, BP, temperature, pO2, arterial pressure

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.