Iloprost
A DRUG Information Sheet
Why am I being prescribed iloprost?
Iloprost is a man-made version of a substance produced naturally in your body, called prostacyclin. It is prescribed for people with severe circulatory problems, for example ulcers of the fingers in people with scleroderma or related conditions.
Iloprost improves the circulation of the blood by:
- widening the blood vessels, which helps them to carry more blood to all areas of the body
- reducing clumping of the red cells in the blood, thus reducing the tendency of the blood to clot
- helping to prevent or repair damage to blood vessels.
Your doctors will prescribe iloprost if they think that you would benefit from improved circulation.
When and how do I take iloprost?
Iloprost is given through a drip into a vein (intravenous infusion) in hospital. The infusion is usually given continuously for approximately 6 hours a day for 5 days in a row. In some hospitals you stay on the ward for 5 days and in other hospitals you attend the day-case unit during the day and go home in the evenings. Your hospital doctor will be able to tell you which system is used at your hospital.
The infusion will be started at a low dose, and then gradually increased to make sure you tolerate the higher doses. For example, if you develop a headache when the dose is increased, then your doctor or nurse will reduce the dose back down to the level at which you did not experience problems. The rate at which iloprost is given also depends on your weight. There are different dose regimes and sometimes longer-term or continuous iloprost is prescribed, for example in people with pulmonary hypertension (a condition which can be associated with scleroderma and which leads to raised pressures in the arteries supplying the lungs).
A 5-day course of iloprost may be prescribed every year, often at the beginning of winter. However, iloprost may be prescribed more frequently if you have particularly severe problems, for example ulcers on your fingers or toes which are not healing with medications taken by mouth.
How long will iloprost take to work?
Iloprost usually starts to work immediately by improving the circulation. People who have been suffering very cold hands or feet often find that they feel warmer straight away. Ulcers may begin to improve within a few days. Iloprost's beneficial effects may carry on for weeks and sometimes even months after the infusion.
In some people iloprost does not seem to work immediately, or does not work at all. Sometimes it can take up to 6 weeks for a person to feel the benefit from an iloprost infusion.
What are the possible risks or side-effects?
The main side-effects of iloprost are facial flushing and headaches, and a fall in blood pressure – therefore your blood pressure will be carefully monitored as discussed later. Nausea, vomiting and diarrhoea are less common side-effects. All side-effects disappear very quickly once the iloprost infusion is stopped or reduced. Muscle cramps or jaw pain may also occur.
Paracetamol and an anti-sickness drug can be given if you experience side-effects. As described above, sometimes the dose of iloprost may be reduced.
What other treatments could be used instead of iloprost?
A number of other drugs are used in the treatment of poor circulation. These are mainly medications taken by mouth. They are often less effective than iloprost in people with severe problems. It is likely that you are already on such medications, and that your doctor feels that these are not sufficient for you. However, your doctor will discuss these other options with you.
Do I need any special checks while on iloprost?
Because iloprost widens the blood vessels it may lower your blood pressure. Nurses will check your blood pressure regularly during the infusion. No other special checks are necessary.
May I take other medicines along with iloprost?
You may take all your usual medications before and after the 5-day course of iloprost. However, on the days when you are receiving iloprost your doctor will probably recommend that you do not take other medications which also widen the blood vessels or lower blood pressure. When you go to the hospital on the first day, take a list of all your medications with you. Your doctor will tell you whether you should leave out any medications on the days when you are having an infusion.
Can I have immunisations while on iloprost?
Iloprost has no effect on immunisations and so you may have immunisations before or after a course of iloprost treatment. In the unlikely event that you need an immunisation during a course of iloprost your hospital doctor will advise you.
May I drink alcohol while taking iloprost?
There is no reason to avoid alcohol before or after a course of iloprost treatment. However, in the evenings after you have received infusions it would be wise to limit alcohol intake as alcohol may make the side-effects of iloprost worse.
Does iloprost affect fertility or pregnancy?
It is not known whether iloprost has any effect on fertility. You should not receive iloprost if you are pregnant. If you know or suspect you may be pregnant you should tell your doctor before receiving any iloprost.
What about breastfeeding?
It is not recommended that you receive iloprost while you are breastfeeding. It is not known whether the drug could pass into the breast milk and the risk to the baby is unknown.
Where can I obtain further information?
If you would like further information about iloprost, or if you have any concerns about your treatment, you should discuss this with your doctor, rheumatology nurse specialist or pharmacist.
Remember to keep all medicines out of reach of children.
PLEASE NOTE: We have made every effort to ensure that the content of this information sheet is correct at time of going to press, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.
