Side Effects of epoprostenol: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Epoprostenol is a prostacyclin analog used to treat pulmonary arterial hypertension (PAH). 15 , 5 , 20 , 1 Many studies have shown that epoprostenol is effective in improving exercise capacity and extending survival. 1 , 27 However, epoprostenol also has strong side effects, especially high output symptoms, ascites, and thrombocytopenia. 1 Therefore, it may be difficult to continue epoprostenol treatment in some cases.

Reasons for Side Effects

The side effects of epoprostenol are due to the action of prostacyclin. Prostacyclin has various effects, including vasodilation and inhibition of platelet aggregation. This action is thought to be the cause of epoprostenol's side effects.

Common Side Effects

High Output Symptoms

Epoprostenol can cause high output symptoms because it has a vasodilating effect. High output symptoms are caused by the heart working too hard and include shortness of breath, palpitations, and dizziness. 1

Ascites

Epoprostenol can cause ascites due to its vasodilating action, which can dilate blood vessels in the abdominal cavity. Ascites is a condition in which fluid accumulates in the abdomen, causing symptoms such as abdominal swelling and weight gain. 1

Thrombocytopenia

Epoprostenol can cause thrombocytopenia because it has an anti-platelet aggregation effect. Thrombocytopenia is a condition in which the number of platelets decreases, causing symptoms such as easy bruising and bleeding. 1

Headache

Headache has been reported as a side effect of epoprostenol. 20

Flushing

Flushing has been reported as a side effect of epoprostenol. 20

Jaw Pain

Jaw pain has been reported as a side effect of epoprostenol. 20

Diarrhea

Diarrhea has been reported as a side effect of epoprostenol. 20

Injection Site Pain

Subcutaneous injection of epoprostenol can cause pain at the injection site. 20

Side Effect Management

High Output Symptoms

High output symptoms may improve by reducing the dosage of epoprostenol. 1 Diuretics may also be effective in some cases.

Ascites

Ascites may improve by reducing the dosage of epoprostenol. 1 Diuretics may also be effective in some cases.

Thrombocytopenia

Thrombocytopenia may improve by reducing the dosage of epoprostenol. 1 Platelet transfusion may also be necessary.

Research Comparisons

Research Similarities

Many studies have shown that epoprostenol is effective in treating PAH. 15 , 5 , 20 , 1 However, epoprostenol has strong side effects, especially high output symptoms, ascites, and thrombocytopenia. 1 Therefore, it may be difficult to continue epoprostenol treatment in some cases.

Research Differences

There may be differences in the effectiveness and side effects of epoprostenol depending on the study. 1 This is thought to be due to differences in the patients studied and the methods of administering epoprostenol.

Precautions for Real-World Application

Epoprostenol is a drug with strong side effects. Therefore, it is important to take it as directed by your doctor. 20 If you experience any side effects, consult your doctor immediately.

Current Research Limitations

There is not enough research on the long-term effects and side effects of epoprostenol. 20 New treatments are also needed to enhance the effectiveness of epoprostenol and reduce its side effects.

Future Research Directions

Research is needed to clarify the long-term effects and side effects of epoprostenol. 20 New treatments are also needed to enhance the effectiveness of epoprostenol and reduce its side effects.

Conclusion

Epoprostenol is a drug that is effective in treating PAH, but it has the challenge of having strong side effects. 15 , 5 , 20 , 1 Therefore, it is important to take it as directed by your doctor and to consult your doctor immediately if you experience any side effects.

Keywords
Benefit Keywords
Improved long-term therapy
PAH treatment
1
PAH treatment
lung transplantation
2
PAH treatment
3
PPHN treatment
4
PAH treatment
5
Improved exercise capacity
Improved hemodynamics
Improved quality of life
6
Exercise capacity improvement
Hemodynamics improvement
PAH treatment
7
Increased CO
Reduced PVR
Reduced mPAP
8
Buerger's disease treatment
9
IP receptor selectivity
Reduced gastric side effects
10
Pulmonary hypertension treatment
11
Improved quality of life
Improved symptoms
12
PAH treatment
13
Cardiovascular protection
14
PAH treatment
15
Exercise capacity
Quality of life
Time to clinical worsening
16
PAH treatment
18
Implantable pump safety
19
Exercise capacity improvement
Quality of life improvement
20
PAH treatment
21
PH-ILD treatment efficacy
22
Idiopathic pulmonary arterial hypertension treatment
23
Pharmacological treatment
24
PAH treatment
25
Transition to oral therapy
26
PAH treatment
27
PAH treatment
Platelet aggregation inhibition
Vascular remodelling reversal
Vasodilation
28
Risk Keywords
thrombocytopenia
2
Low bioavailability
Short half-life
Side effects
3
Dyspepsia
Headache
6
Mild side effects
7
Limited revascularisation
Side effects
9
Clinical decompensation
Severe side effects
12
Systemic vasodilation
13
Cardiovascular side-effects
14
Hypotension
15
Adherence challenges
Catheter-related infections
Infusion site pain
16
Gastrointestinal side effects
Neurologic side effects
Vascular side effects
17
Surgery risk
19
Diarrhea
Flushing
Headache
Infusion site pain
Jaw pain
20
Side effects
21
Inhaled prostacyclin side effects
22
Hereditary susceptibility
24
Severe sequelae
26
Literature analysis of 28 papers
Positive Content
27
Neutral Content
0
Negative Content
1
Article Type
1
2
4
10
27
3.

Targeted treprostinil delivery inhibits pulmonary arterial remodeling.

Author: LiuAijun, LiBin, YangMing, ShiYongying, SuJunwu

PAH treatment
Low bioavailability
Short half-life
Side effects

Treprostinil (TPS), a prostacyclin used for pulmonary arterial hypertension (PAH) treatment, has limited efficacy due to low bioavailability, short half-life, and systemic side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Inhaled Epoprostenol for Pulmonary Hypertension Treatment in Neonates: A 12-Year Experience.

Author: Berger-CaronFrédérique, PiedboeufBruno, MorissetteGeneviève, SimonyanDavid, ChétaillePhilippe, PellerinAnnie, HébertAudrey

PPHN treatment

This study describes the use of inhaled epoprostenol (iPGI<sub>2</sub>) for managing refractory persistent pulmonary hypertension of the newborn (PPHN) in a specific institution.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

[Pulmonary hypertension and right ventricular failure. Part X. Prostanoids in the treatment of primary pulmonary arterial hypertension].

Author: BatyralievT A, MakhmutkhodzhaevS A, EkinciE, PataraiaS A, PershukovI V, SidorenkoB A, PreobrazhenskiĭD V

PAH treatment

This study reviews literature data on the epidemiology, classification, pathogenesis, and treatment of pulmonary arterial hypertension (PAH). It focuses on the use of prostacyclin and its synthetic analogues in patients with primary or associated PAH.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Russian

6.

Addition of sildenafil to long-term intravenous epoprostenol therapy in patients with pulmonary arterial hypertension: a randomized trial.

Author: SimonneauGérald, RubinLewis J, GalièNazzareno, BarstRobyn J, FlemingThomas R, FrostAdaani E, EngelPeter J, KramerMordechai R, BurgessGary, CollingsLorraine, CossonsNandini, SitbonOlivier, BadeschDavid B,

Improved exercise capacity
Improved hemodynamics
Improved quality of life
Dyspepsia
Headache

Adding oral sildenafil to long-term intravenous epoprostenol therapy in patients with pulmonary arterial hypertension improves exercise capacity, hemodynamic measurements, time to clinical worsening, and quality of life. However, it also increases the risk of headache and dyspepsia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

[Sildenafil therapy for pulmonary hypertension: a prospective study].

Author: LuXian-ling, XiongChang-ming, ShanGuang-liang, LiuZhi-hong, NiXin-hai, ChengXian-sheng, GuQing, ZhaoZhi-hui, ZengWei-jie, ZhuFeng, HeJian-Guo

Exercise capacity improvement
Hemodynamics improvement
PAH treatment
Mild side effects

This study found that oral sildenafil therapy improved exercise capacity, WHO functional class, and hemodynamics in patients with pulmonary arterial hypertension.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : Chinese

8.

Acute effects of the combination of sildenafil and inhaled treprostinil on haemodynamics and gas exchange in pulmonary hypertension.

Author: VoswinckelRobert, ReichenbergerFrank, EnkeBeate, KreckelAndre, KrickStefanie, GallHenning, SchermulyRalph Theo, GrimmingerFriedrich, RubinLewis J, OlschewskiHorst, SeegerWerner, GhofraniHossein A

Increased CO
Reduced PVR
Reduced mPAP

The combination of oral sildenafil and inhaled treprostinil was well tolerated and induced additive pulmonary selective vasodilatation in pulmonary hypertension patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Pharmacological treatment for Buerger's disease.

Author: CacioneDaniel G, MacedoCristiane R, do Carmo NovaesFrederico, Baptista-SilvaJose Cc

Buerger's disease treatment
Limited revascularisation
Side effects

Buerger's disease is a rare disease that affects the blood vessels in the arms and legs. The cause is unknown, but smoking is a major risk factor. This review discusses the current treatments for Buerger's disease, which include smoking cessation and medications to improve blood flow.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Inhaled therapy for the management of perioperative pulmonary hypertension.

Author: ThunbergC A, MorozowichS T, RamakrishnaHarish

Pulmonary hypertension treatment

This review discusses the perioperative therapy of pulmonary hypertension (PH) using inhaled vasodilators, which can effectively reduce pulmonary artery pressure while avoiding systemic hypotension.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Safety and efficacy of transition from systemic prostanoids to inhaled treprostinil in pulmonary arterial hypertension.

Author: de Jesus PerezVinicio A, RosenzweigErica, RubinLewis J, PochDavid, BajwaAbubakr, ParkMyung, JainMohit, BourgeRobert C, KudelkoKristina, SpiekerkoetterEdda, LiuJuliana, HsiAndrew, ZamanianRoham T

Improved quality of life
Improved symptoms
Clinical decompensation
Severe side effects

This retrospective study investigates the transition of patients with pulmonary arterial hypertension (PAH) from intravenous/subcutaneous prostanoids to inhaled treprostinil. While generally well-tolerated, close monitoring for clinical decompensation is recommended.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Inhalational therapy for pulmonary arterial hypertension: current status and future prospects.

Author: GuptaVivek, AhsanFakhrul

PAH treatment
Systemic vasodilation

Inhalational delivery of anti-PAH drugs offers an attractive alternative to conventional routes of administration for the treatment of pulmonary arterial hypertension (PAH).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Eicosanoids, prostacyclin and cyclooxygenase in the cardiovascular system.

Author: MitchellJane A, KirkbyNicholas S

Cardiovascular protection
Cardiovascular side-effects

This review summarizes the history, biology, and cardiovascular function of key eicosanoids with particular focus on prostacyclin and other COX products. It discusses how our knowledge of these pathways can be applied in future drug discovery and be used to explain the cardiovascular side-effects of NSAIDs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Titration of pulmonary arterial hypertension therapeutics: Experience-based recommendations.

Author: LombardiSandra, KingmanMartha, DuncanMaribeth, BerngardSamuel Clark, FernandesTimothy

Exercise capacity
Quality of life
Time to clinical worsening
Adherence challenges
Catheter-related infections
Infusion site pain

This article provides recommendations for dose titration schemes for pulmonary arterial hypertension (PAH) medications that require individualized dosing in adult patients. It emphasizes the importance of careful titration to maximize therapeutic effectiveness while minimizing side effects, considering different routes of administration and potential challenges they present. The article stresses the critical role of patient education, frequent monitoring, and treatment adherence for optimal outcomes.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Ambulatory Transition from Parenteral Prostanoid to Inhaled Treprostinil in Patients with Pulmonary Arterial Hypertension.

Author: KimmigLucas M, LiaoChuanhong, BagRemzi

PAH treatment

Transitioning from intravenous or subcutaneous prostanoid drugs to inhaled treprostinil in clinically stable patients with pulmonary arterial hypertension is a viable option. Further research is needed to determine the optimal setting for transition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Procedural safety of a fully implantable intravenous prostanoid pump for pulmonary hypertension.

Author: RichterManuel J, EwertRalf, WarnkeChristian, GallHenning, ClassenSimon, GrimmingerFriedrich, MayerEckhard, SeegerWerner, GhofraniHossein-Ardeschir

Implantable pump safety
Surgery risk

This abstract explores the safety of a fully implantable pump for continuous intravenous treprostinil delivery in patients with severe pulmonary arterial hypertension. The study aimed to evaluate the safety of the pump insertion procedure, which can be a major risk for these patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

20.

Treprostinil for the treatment of pulmonary arterial hypertension.

Author: TorresFernando, RubinLewis J

Exercise capacity improvement
Quality of life improvement
Diarrhea
Flushing
Headache
Infusion site pain
Jaw pain

Treprostinil, a stable prostacyclin analog, is approved for the treatment of pulmonary arterial hypertension (PAH). This article reviews the efficacy and safety data for parenteral, inhaled and oral administration of treprostinil.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

[Treatment of pulmonary hypertension].

Author: Damps-KonstańskaIwona, KonstańskiZdzisław, JassemEwa

PAH treatment
Side effects

Pulmonary hypertension is a serious condition that causes high blood pressure in the lungs. This article discusses the different types of pulmonary hypertension, the treatment options available, and the emerging role of combination therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Polish

22.

Practical considerations in the management of inhaled prostacyclin therapy for pulmonary hypertension associated with interstitial lung disease (WHO group 3).

Author: LeeCharlie, HamlynJoan, PorcelliJulie, SchmitAnn

PH-ILD treatment efficacy
Inhaled prostacyclin side effects

Inhaled treprostinil (Tyvaso) has been approved for the treatment of pulmonary hypertension associated with interstitial lung disease (PH-ILD). This review provides practical considerations for optimizing the management of PH-ILD patients, including patient education, monitoring, titration methods, and mitigation of side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Pharmacological treatment for Buerger's disease.

Author: CacioneDaniel G, MacedoCristiane R, Baptista-SilvaJose C C

Pharmacological treatment
Hereditary susceptibility

Buerger's disease, a non-atherosclerotic inflammatory condition affecting small and medium-sized blood vessels, often has no revascularization options. This review discusses the pharmacological treatment options for patients with severe complications, such as ischemic ulcers or rest pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Treprostinil Administered to Treat Pulmonary Arterial Hypertension Using a Fully Implantable Programmable Intravascular Delivery System: Results of the DelIVery for PAH Trial.

Author: BourgeRobert C, WaxmanAaron B, Gomberg-MaitlandMardi, ShapiroShelley M, TarverJames H, ZwickeDianne L, FeldmanJeremy P, ChakinalaMurali M, FrantzRobert P, TorresFernando, CerkvenikJeffrey, MorrisMarty, ThalinMelissa, PetersonLeigh, RubinLewis J

PAH treatment

A fully implantable intravascular delivery system for treprostinil infusion shows promise for treating severe pulmonary arterial hypertension (PAH). This novel system could offer a less invasive and more convenient alternative to current pump-delivered continuous therapy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

26.

Transition from intravenous epoprostenol to oral or subcutaneous therapy in pulmonary arterial hypertension: a retrospective case series and systematic review.

Author: ParkKirily, OstrowDavid, LevyRobert D, SwistonJohn

Transition to oral therapy
Severe sequelae

Transitioning patients with advanced pulmonary arterial hypertension (PAH) from intravenous epoprostenol to newer oral or subcutaneous therapies is a feasible and safe practice.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

One-year experience with intravenous treprostinil for pulmonary arterial hypertension.

Author: BenzaRaymond L, TapsonVictor F, Gomberg-MaitlandMardi, PomsAbigail, BarstRobyn J, McLaughlinVallerie V

PAH treatment

Continuous intravenous treprostinil, a prostacyclin analog, holds potential advantages over intravenous epoprostenol for treating advanced pulmonary arterial hypertension (PAH). However, long-term efficacy and safety data for intravenous treprostinil in PAH are limited.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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