Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Epoprostenol

Generic name
Epoprostenol
Brand name
ATC Code
B01AC09

Pharmacokinetics in children

Half-life: < 6 minutes

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dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

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Available formulations

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Dosages

Pulmonary hypertension, sepsis with severely reduced circulation
  • Intravenous
    • 1 month up to 18 years
      • Initial dose: 0.5 - 3 ng/kg/minute, continuous infusion.
      • Maintenance dose: increase gradually depending on treatment response and adverse effects. in 1-2 ng / kg / min increments every 15-120 min to 20 - 40 ng/kg/minute, continuous infusion.

      • Large variability between patients for the optimum dosage. Limited scientific evidence.
        Treatment by or after consultations with a paediatric specialist (paediatric cardiology), neonatologist or intensive care specialist who has experience with using epoprostenol for this indication.

    • Term neonate
      • Initial dose: 0.5 - 3 ng/kg/minute, continuous infusion.
      • Maintenance dose: increase gradually depending on treatment response and adverse effects. in 1-2 ng / kg / min increments every 15-120 min to 20 - 40 ng/kg/minute, continuous infusion.

      • Large variability between patients for the optimum dosage. Limited scientific evidence.
        Treatment by or after consultations with a paediatric specialist (paediatric cardiology), neonatologist or intensive care specialist who has experience with using epoprostenol for this indication.

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Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects

No information is present at this moment.

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions

No information available on specific warnings and precautions in children.

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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Vitamin K antagonists
B01AA07
B01AA04
Heparin group
B01AB04
B01AB09
B01AB05
B01AB01
B01AB06
B01AB10
Platelet aggregation inhibitors excl. heparin
B01AC06
B01AC04
Enzymes
B01AD02
B01AD01
B01AD04
Direct thrombin inhibitors
B01AE07
Direct factor Xa inhibitors
B01AF02
B01AF01

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References

  1. Doran A, et al, Advances in prostanoid infusion therapy for pulmonary arterial hypertension, J Infus Nurs, 2008, Nov-Dec;31(6), 336-45
  2. Ivy DD, et al, Transition of stable pediatric patients with pulmonary arterial hypertension from intravenous epoprostenol to intravenous treprostinil, Am J Cardiol, 2007, Mar 1;99(5), 696-8
  3. Rosenzweig EB, et al, Pulmonary arterial hypertension in children, Pediatr Pulmonol, 2004, Jul;38(1), 2-22
  4. Lammers AE, et al, Epoprostenol treatment in children with severe pulmonary hypertension, Heart, 2007, Jun;93(6), 739-43
  5. Melnick L, et al, Effectiveness of transition from intravenous epoprostenol to oral/inhaled targeted pulmonary arterial hypertension therapy in pediatric idiopathic and familial pulmonary arterial hypertension, Am J Cardiol, 2010, May 15;105(10), 1485-9
  6. Nakayama T, et al, Efficacy and limitations of continuous intravenous epoprostenol therapy for idiopathic pulmonary arterial hypertension in Japanese children, Circ J, 2007, Nov;71(11), 1785-90
  7. Farber HW, et al, Practical considerations for therapies targeting the prostacyclin pathway, Eur Respir Rev, 2016, 25, 361–363
  8. Hansmann G, et al., 2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension: The European Pediatric Pulmonary Vascular Disease Network (EPPVDN), endorsed by AEPC, ESPR and ISHLT, J Heart Lung Transpl,, 2019, 38(9), 879-901
  9. Barnes H, et al., Prostacyclin for pulmonary arterial hypertension , Cochrane Database Syst Rev. 2019 May; 2019(5), 2019, May 1;5(5), CD012785
  10. Barnes H, et al., Prostacyclin for pulmonary arterial hypertension, Cochrane Database Syst Rev. 2019 May; 2019(5), 2019, May 1;5(5), CD012785

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Changes

Changes