Parenteral Manual

Epoprostenol

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): 
Flolan, Prostacyclin, PGI2, PGX
Classification: 
Vasodilator, Platelet aggregation inhibitor
Original Date: 
January 2007
Revised Date: 
September 2011
Indications: 
  • Pulmonary Hypertension
Reconstitution and Stability: 
  • Available in 2 vial sizes; 0.5 mg and 1.5 mg
  • Reconstituted vial stable 8 hrs room temperature, 24 hrs refrigerated. Protect from light.
  • Reconstitute 0.5 mg vial with 5 mL of sterile diluent for Flolan for a 100 mcg/mL solution
  • Reconstitute 1.5 mg vial with 15 mL of sterile diluent for Flolan for a 100 mcg/mL solution
  • Once reconstituted, further dilute with sterile diluent for Flolan to an appropriate volume (note:  the final concentration can be any number up to a maximum concentration of 70 mcg/mL. The concentration is usually a result of getting the infusion to run at a convenient hourly rate)
  • Diluted solution stable for 24 hours refrigerated.
  • Protect from light - cover syringe with foil and tubing with tape
  • Diluted solution is stable for 8 hours at room temperature. However at CHEO we assign a 6 hour stability to account for time lost due to checking/delivery etc.... This drug can be life sustaining
Compatibility: 
  • Compatible ONLY with sterile diluent for Flolan. Do not mix with any other IV solution or medication
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 a central line. It can be delivered through a peripheral IV temporarily until central access is accomplished

Usual dilution: Dilute required dose with sterile diluent for Flolan up to maximum of 70 mcg/mL

 

 

Dosage: 

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

  • Initial: 2 nanograms/kg/minute
  • Titrate dose upwards. Doses up to 40 nanograms/kg/minute have been used

Note: 1000 nanograms = 1 microgram

Potential hazards of parenteral administration: 
  • Hypotension, Tachycardia or bradycardia, flushing
  • bleeding
  • headache, dizziness
  • nausea, vomiting, diarrhea, abdominal pain
  • musculoskeletal pain
  • anxiety, nervousness, agitation
Notes: 
  • monitor I&O, weight daily
  • Baseline renal and liver function tests before therapy begins
  • Monitor BP Q15 minute x 1 hour, Q 30 minutes x 1 hour, then Q1H x 1 hour at the beginning of treatment or when infusion dose increases. Then Q4H if stable
  • Monitor O2 sats, PTT, INR and platelets

Abrupt withdrawal will result in symptoms of rebound pulmonary hypertension (dyspnea, dizziness, weakness) and rare occurrences of death have been reported. If the central line becomes blocked, start a peripheral line STAT and transfer the infusion. Do not flush the blocked central line. Central access must be regained as soon as possible

References: 

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