CLINICAL USE

Antiplatelet agent: Prevention of early myocardial infarction in patients with unstable angina or non-ST segment elevation myocardial infarction, and with last episode of chest pain within 12 hours

DOSE IN NORMAL RENAL FUNCTION

Initially 0.4 mcg/kg/minute for 30 minutes then 0.1 mcg/kg/minute for at least 48 hours

PHARMACOKINETICS

  • Molecular weight                           : 495.1
  • %Protein binding                           : 65
  • %Excreted unchanged in urine     : 66
  • Volume of distribution (L/kg)       : 22–42 litres
  • half-life – normal/ESRD (hrs)      : 1.5–2/increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    30–50 Dose as in normal renal function 10–30 Give 50% of dose

  • <10           : Give 50% of dose

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                : Unknown dialysability. Dose as in GFR <10 mL/min
  • HD                     : Dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   : Dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      : Unknown dialysability. Dose as in GFR=10–30 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs Iloprost: increased risk of bleeding

  • Heparin: increased risk of bleeding

    ADMINISTRATION

    Reconstition

    –

    Route

    IV infusion

    Rate of Administration

    0.1–0.4 mcg/kg/minute

    Comments

    Add 50 mL of the concentrate (250 mcg/ mL) to 250 mL sodium chloride 0.9% or glucose 5%, to give a final concentration of 50 mcg/mL (remove 50 mL from bag first)

    OTHER INFORMATION

    Antiplatelet effect lasts for about 4–8 hours after stopping infusion Main side effect is bleeding Increased risk of bleeding once renal function falls to a GFR<60 mL/min – monitor carefully .

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