Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Prostacyclin (PGI2) — Severe Pulmonary Arterial Hypertension

Epoprostenol

Brand names: Flolan, Veletri

Epoprostenol is a prostacyclin (PGI2) analogue given by continuous intravenous infusion, used in pulmonary arterial hypertension and as an antiplatelet agent during renal replacement therapy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a potent vasodilator and inhibitor of platelet aggregation that acts via prostacyclin receptors to relax vascular smooth muscle, including in the pulmonary vasculature.

Prescribing in practice

  • Abrupt interruption of the infusion can cause life-threatening rebound pulmonary hypertension, so continuity of the infusion and line care are critical.
  • It has a very short half-life and is unstable, requiring careful reconstitution and a dedicated central line for chronic use.
  • Systemic hypotension and infusion-related effects such as flushing, jaw pain and headache are common.

Monitoring

Monitor blood pressure and haemodynamic status closely, with continuous oversight of the infusion line.

Counselling the patient

  • This medicine is given as a continuous drip and must never be stopped suddenly.
  • Report any problems with the infusion line or pump immediately.
  • Flushing, jaw pain and headache can occur and should be reported if troublesome.

Evidence & guidelines

Continuous intravenous epoprostenol improved survival and exercise capacity in randomised trials of severe pulmonary arterial hypertension.

Reference: Barst RJ et al. NEJM 1996; NICE TA238 (Epoprostenol for PAH); ESC/ERS PAH Guidelines 2022; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways