Neonatal Drug Therapy Manual

Alprostadil E1

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

Updated June 19, 2024 - 3:43pm

Alternate Name(s): 
Prostaglandin E1, PGE 1, Prostin VR
Classification: 
Prostaglandin
Original Date: 
March 1993
Revised Date: 
March 2024
Indications: 
  • Maintain patency of the ductus arteriosus in neonates with ductus dependent cardiac lesions until surgery
Administration: 
  • IV continuous infusion. Infusion should not be interrupted as duration of effect is short
  • Preductal vein preferred
Dosage: 
  • Initial:
    • 0.05 to 0.1 mcg/kg/minute. 
    • in preterm neonates with cardiac defects, initial dose for infusion should be started at 0.01 to 0.02 mcg/kg/minute.
  • Maintenance:
    • 0.01 to 0.4 mcg/kg/minute
    • Use lowest effective dose
Side Effects: 
  • CNS: seizure-like activity, fever
  • CVS: hypotension, bradycardia, arrhythmias, tachycardia, flushing
  • Endocrine and metabolic: hypoglycemia, hypokalemia

  • GI: diarrhea

  • Hematologic: disseminated intravascular coagulation, hemorrhage, thrombocytopenia
  • Renal: anuria

  • Respiratory: apnea

Parameters to Monitor: 
  • BP, HR,
  • Temperature
  • RR
  • Oxygen saturation - be prepared to ventilate
Reconstitution and Stability: 
  • Alprostadil (PGE1) 500 mcg/mL
    • Add 0.4 mL (200 mcg) to 19.6 mL D5W
    • Final concentration: 10 mcg/mL
Compatibility: 

- Solutions Compatible: D5W, D10W, 0.9% NaCl

- Y-site Compatible: cefotaxime, dobutamine, dopamine, fentanyl, gentamicin, heparin, midazolam, morphine,  vancomycin

 

References: 
  • Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 17th Edition. Hudson: Lexi-Comp Inc.; 2010
  • Trissel LA.  Handbook on Injectable Drugs. 16th Edition.  Bethesda:  American Society of health-System Pharmacists; 2011 
  • Young TE, Mangum B. Neofax(R). 20th Edition. Raleigh: Acorn Publishing; 2000-2003.
  • Children’s Hospital of Eastern Ontario/Ottawa Hospital General Campus Division of Neonatology- Neonatal Mortality Review July 2021 - June 2022 (Summary of Recommendations)

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