Iloprost is one of the prostanoids. These are a family of drugs that work in a similar way to substances called prostaglandins, which occur naturally in the body, albeit in much smaller quantities. In terms of PH, they are powerful vasodilators (open up blood vessels) to allow more blood to flow through the narrowed vessels in the lungs.
Iloprost is inhaled directly into your lungs through a special nebuliser. Once in the lungs, iloprost is quickly broken down by the body. This means that you need to use the nebuliser frequently through the day (six to nine times a day is recommended) in order to achieve maximum benefit. Iloprost can also be given intravenously, like epoprostenol.
Do not take iloprost if you:
Have had an allergic reaction to iloprost in the past.
• Have conditions where the sideeffects of iloprost may increase your risk of a bleed (e.g. active stomach ulcers, trauma, bleeding in your head).
• Severe coronary heart disease or unstable angina.
• Myocardial infarction within the last six months.
• Unsupervised heart failure (all PH patients will be supervised by their centre).
• Severe abnormal heart rhythms.
• Cerebrovascular events (e.g. transient ischaemic attack, stroke) within the last three months.
• Pulmonary hypertension due to venous occlusive disease.
• Have heart defects not related to your pulmonary hypertension.
Nebulised iloprost can potentially cause a range of side effects. These include hypotension (low blood pressure), nausea, diarrhoea, headache, flushing, cough, jaw pain and mouth/throat irritation.
Prostanoids are regarded as the most potent form of PH treatment. Iloprost gives lower doses but is directly targeted at the lungs to minimise the whole-body (sometimes referred to as systemic) side effects.