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Flolan®

This product is manufactured by GlaxoSmithKline using the ingredient epoprostenol sodium.

This product is taken via intradermal injection.

Why is it prescribed?

Epoprostenol sodium is indicated for the long-term i.v. treatment of primary pulmonary hypertension. It can also be used to treat secondary pulmonary hypertension due to scleroderma spectrum of diseases in NYHA functional Class III and Class IV patients who did not respond adequately to conventional therapy

Flolan® is used to treat a lung condition known as pulmonary hypertension. This is where the blood pressure is high in the main blood vessels of the lungs. This increased pressure means your heart has to work harder to pump blood through your lungs. Pulmonary hypertension weakens your heart and eventually may cause heart failure. Flolan® is a medication used to help reduce this blood pressure and relieve some of the stress on the heart and lungs.
Flolan® is a very complicated medication to administer. The drug must be prepared daily under rigorous conditions. You will need to learn about the medicine, the delivery system (the central venous catheter) and the pump. You will to have a 'significant other' who is willing to learn along with you and to be available in case of need. Your doctor or nurse will teach you and your partner how to prepare the medication and use the pump for administering the medication.


Alternatives

Other products that have the same ingredient as Flolan® are •Caripul® •

See other products used in the treatment of •primary pulmonary hypertension •secondary pulmonary hypertension •

Flolan® is administered by continuous i.v. infusion through an indwelling venous catheter. The dose is determined based on patient body weight and then gradually increased until the patient experiences side effects or until no further benefit is gained.
The first dose of Flolan® is administered and monitored in the hospital. The patient and caregiver will be educated on how to continue therapy at home.


Epoprostenol is a vasodilator. Vasodilators open up (dilate) the blood vessels in your body by relaxing the muscle walls of the blood vessels. This helps to lower blood pressure and allow blood to flow more easily.


Along with its therapeutic benefit, epoprostenol sodium can cause the following side effects:

  • headache
  • jaw pain
  • pain
  • nausea and vomiting
  • diarrhea
  • flushing and redness of the face
  • stomach pain
  • anxiety
  • pain at the injection site
  • drowsiness


Epoprostenol sodium may cause serious side effects. If you experience any of the following side effects go to the hospital immediately:

  • unusually slow or fast heartbeats, or feeling dizzy or faint, which can be signs of low blood pressure
  • chills, with or without shaking, and fever which may be signs of a blood infection
  • chest pain

Contact your physician if you experience the following side effects:

  • Bleeding that lasts longer than usual or which cannot be stopped, bruising more easily than normal

Treatment with epoprostenol sodium may be continuous and for long periods. Epoprostenol sodium is infused continuously through a permanent indwelling central catheter via a small, portable infusion pump. The patient and their caregivers must commit to learning how to care for the central venous catheter, and how to properly prepare and administer epoprostenol sodium via the pump.
Discontinuing epoprostenol sodium abruptly can result in a rebound pulmonary hypertensive effect that may cause shortness of breath, dizziness, weakness and even death.

Do not use if you:

  • are allergic to epoprostenol, or any ingredients of the medication
  • are allergic to any medications with a similar chemical structure to epoprostenol
  • have fluid in the lungs when starting the medication
  • have congestive heart failure

Patients being treated with epoprostenol sodium should avoid exposing themselves to prolonged excessive heat. The use of saunas, or hot tubs and sunbathing may result in the patient's blood pressure dropping too low.
Epoprostenol use has been associated with an increased incidence of bradycardia (slow heart rate) in patients with pulmonary hypertension and with episodes of severe hypotension (low blood pressure), including fatalities.
Patients using epoprostenol sodium may be at an increased risk of bleeding.

Pregnancy: Very little information since patients with pulmonary hypertension are advised to avoid pregnancy. Benefit to the mother likely outweighs risk to the baby.
Breastfeeding: No information but unlikely to be harmful for the infant.