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Veletri

epoprostenol
Used for Pulmonary Hypertension
Used for Pulmonary Hypertension

Veletri (epoprostenol) is a prostacyclin vasodilator used to treat pulmonary arterial hypertension (PAH) in adults. It works by relaxing the blood vessels in your lungs, which lowers the pressure. Veletri (epoprostenol) is given as an injection through your veins continuously through an infusion pump. It's common to experience side effects such as flushing, headache, nausea, and vomiting from this medication.

Last reviewed on January 16, 2024
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What is Veletri (epoprostenol)?

What is Veletri (epoprostenol) used for?

How Veletri (epoprostenol) works

Veletri (epoprostenol) is a prostacyclin vasodilator. Prostacyclins work by relaxing muscles in the arteries (blood vessels), which leads to vasodilation. Vasodilation means that the blood vessels widen, which allows more blood to flow through them. In addition, prostacyclins prevent platelets, pieces of cells found in the blood, from sticking to each other. This also helps improve blood flow.

PAH occurs when blood can't flow freely through the arteries in your lungs. This raises the blood pressure in your lungs, causing your heart to have to work harder to send blood to your lungs for oxygen. Veletri (epoprostenol) helps with PAH because it improves the blood flow in your arteries.

Are you looking for information on epoprostenol (Flolan) instead?

Drug Facts

Common BrandsVeletri
Drug ClassProstacyclin vasodilator
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Veletri (epoprostenol)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Flushing (58%)
  • Headache (49%)
  • Nausea/vomiting (32%)
  • Low blood pressure (16%)
  • Anxiety, nervousness, or agitation (11%)
  • Chest pain (11%)

Other Side Effects

  • Dizziness
  • Slow heart rate
  • Stomach pain
  • Muscle and bone pain
  • Shortness of breath
  • Back pain

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Excess fluid in the lungs: shortness of breath, cough, chest pain, fatigue
  • Bleeding problems: unusual or easy bleeding or bruising, vomiting or coughing up blood, blood in your urine or stool

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Abdominal or stomach pain

arm, back, or jaw pain

bladder pain

bleeding gums

bloating or swelling of the face, arms, hands, lower legs, or feet

bloody or cloudy urine

blurred vision

changes in skin color

chest congestion

chest pain or discomfort

chest tightness or heaviness

chills

cold hands and feet

confusion

constipation

convulsions

cough or hoarseness

coughing up blood

decreased urine

depression

diarrhea

difficult, burning, or painful urination

difficulty with breathing or swallowing

dilated neck veins

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

dry mouth

extreme fatigue

fast, pounding, or irregular heartbeat or pulse

feeling of warmth

fever

headache

incoherent speech

increased menstrual flow or vaginal bleeding

increased thirst

increased urination

local infection at the catheter site

loss of appetite

metallic taste

muscle pain or cramps

muscle weakness

nausea or vomiting

nosebleeds

numbness or tingling in the hands, feet, or lips

pain at the injection site

pain, redness, or swelling in the arm or leg

paleness of the skin

prolonged bleeding from cuts

rapid weight gain

red or black, tarry stools

redness of the face, neck, arms, and occasionally, upper chest

sweating

swelling of the face, fingers, feet, or lower legs

tightness in the chest

tingling of the hands or feet

unusual tiredness or weakness

weight gain or loss

Less common

Altered or abnormal touch sensation or sensitivity

blue lips and fingernails

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

coughing that sometimes produces a pink frothy sputum

difficult, fast, or noisy breathing

inability to speak

increased sweating

numbness or tingling in the hands, feet, or lips

pain or discomfort in the arms, jaw, back, or neck

seizures

severe or sudden headache

severe pain in the chest

slurred speech

sudden onset of severe breathing

temporary blindness

weakness in the arm or leg on one side of the body, sudden and severe

weakness or heaviness of the legs

Incidence not known

Feeling of fullness

high fever

pinpoint red spots on the skin

sensitivity to heat

sores, ulcers, or white spots on the lips or in the mouth

swollen glands

trouble sleeping

troubled breathing with exertion

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Change in vision

difficulty having a bowel movement (stool)

difficulty with moving

heartburn

hives or welts

impaired vision

itching

joint pain

lack of appetite

lack or loss of strength

loss of interest or pleasure

muscle pains or stiffness

redness of the skin

shakiness in the legs, arms, hands, or feet

skin rash, encrusted, scaly and oozing

sores on the skin

swollen joints

tiredness

trembling or shaking of the hands or feet

trouble concentrating

Less common

Acid or sour stomach

belching

blurred vision or other changes in vision

excess air or gas in the stomach or intestines

indigestion

leg cramps

passing gas

sleepiness or unusual drowsiness

stomach discomfort or upset

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Veletri (epoprostenol)

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Pros

Can help manage symptoms of PAH and improve your ability to exercise

Mixed vials can be stored in the refrigerator for up to 8 days.

Infusion pump continuously delivers your correct dose

Dose can be adjusted by your provider based on your response

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Cons

Might be hard to use for some people because of complicated instructions

Requires caring for an IV catheter after it’s inserted through a minor surgical procedure

Can cause serious problems if medication is stopped or interrupted suddenly

Can cause unpleasant side effects, like headache and nausea

pharmacist-tips

Pharmacist tips for Veletri (epoprostenol)

pharmacist
  • Be sure to have a backup infusion pump and extra supplies needed for your infusion of Veletri (epoprostenol). If a problem with your pump causes an interruption in your dose, it can cause serious side effects.

    • Your healthcare provider will give you instructions on how to prepare Veletri (epoprostenol) and how to use the infusion pump. Ask your provider if you're unsure about any steps of the treatment process.

      • Veletri (epoprostenol) should only be mixed with sterile water for injection or sodium chloride 0.9%. Never mix it with any other liquid.

        • Don't use Veletri (epoprostenol) if the mixed solution looks discolored or has particles in it. Talk to your healthcare provider if you're unsure about whether your medication is safe to use.

          • Wash your hands with soap and water, and dry with a clean towel before mixing Veletri (epoprostenol) or caring for your IV catheter. Doing these things will help prevent an infection.

            • Unopened vials of Veletri (epoprostenol) can be stored at room temperature. Keep them in the original carton to protect them from sunlight.

              • Once mixed, the medication can last for up to 8 days when stored in the refrigerator. Throw away any leftover mixed medication after this time.

                • It's common to experience symptoms like low blood pressure, flushing, nausea, vomiting, dizziness, and headache when you start taking Veletri (epoprostenol). Your healthcare provider should check your blood pressure regularly during treatment, especially when you start the medication and after your dose is changed.

                  • Veletri (epoprostenol) works to improve blood flow in the lungs by preventing platelets from clumping together. But this can result in bleeding problems for some people. Talk to your provider if you have any unusual bleeding or bruising, especially if you're taking an anticoagulant (blood thinner) along with Veletri (epoprostenol).

                    faqs

                    Frequently asked questions about Veletri (epoprostenol)

                    What is the difference between Flolan and Veletri?
                    Flolan and Veletri are two brand name medications that contain epoprostenol. The main difference between them is the way each medication is prepared. Flolan is mixed with pH 12 sterile diluent, while Veletri is mixed with sterile water for injection or sodium chloride 0.9%. Speak with your provider to determine which medication is best for you.
                    What is the difference between Remodulin and Veletri?
                    Treprostinil (Remodulin) works similarly to Veletri to treat PAH. Both medications are given as continuous infusions through an infusion pump. The main difference is that treprostinil (Remodulin) can be infused under the skin or into the veins, but Veletri (epoprostenol) can only be infused into the veins. Talk with your provider if you've more questions about how these two medications differ.
                    Can Veletri (epoprostenol) be inhaled?
                    Veletri (epoprostenol) is currently only FDA-approved for use as an intravenous injection. However, some small studies suggest it might work well for conditions like acute respiratory distress syndrome (ARDS) when it's inhaled (breathed in). Some hospitals have special protocols for using inhaled Veletri (epoprostenol). But this is considered an off-label use, and more research is needed to know if using the medication this way is safe or effective.
                    How well does Veletri (epoprostenol) work for pulmonary hypertension?
                    In clinical studies, people who used Veletri (epoprostenol) had better blood flow to the lungs compared to people who took traditional therapy for PAH (e.g., digoxin, water pills) after 2 to 3 months of treatment. Additionally, people who used Veletri (epoprostenol) in combination with traditional treatments saw greater improvement in their ability to exercise compared to those who took traditional treatments alone. Follow up with your provider to learn about the possible benefits of Veletri (epoprostenol) for your condition.
                    How is Veletri (epoprostenol) administered?
                    Veletri (epoprostenol) is taken around the clock through an IV line attached to a portable pump. The pump is programmed to deliver the correct dose continuously throughout the day. When you take Veletri (epoprostenol) for the first time, it should be given by your healthcare provider in order to find the safest and most effective dose for you. If your provider decides that you can get the treatments at home, you'll need to be trained on the correct way to mix and give the medication.
                    Can you take Veletri (epoprostenol) during pregnancy?
                    A small amount of research hasn't associated Veletri (epoprostenol) with birth defects or miscarriage when taken by pregnant females. However, the risk can't be ruled out. If you're pregnant or thinking of becoming pregnant, talk to your provider about the risks and benefits of taking this medication. It's important to treat PAH during pregnancy to prevent harm to yourself of your unborn baby.
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                    What are the risks and warnings for Veletri (epoprostenol)?

                    Veletri (epoprostenol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                    risk-warning

                    Long-term use and dose adjustments

                    Many people will need to take Veletri (epoprostenol) long-term, and will need their dose adjusted as symptoms change. Your provider will help you watch for side effects due to raising your dose, such as low blood pressure, flushing, nausea, vomiting, dizziness, and headache. Make sure to wash your hands with soap and water when preparing and giving your dose to lower your risk of infection. Your provider will likely also give you a blood thinner to lower the risk of blood clots.

                    risk-warning

                    Worsening of PAH after suddenly stopping Veletri (epoprostenol)

                    Don't make changes to your Veletri (epoprostenol) dose without first talking to your provider. Sudden changes in dose or suddenly stopping Veletri (epoprostenol) can cause symptoms of PAH to come back. These symptoms can be worse than they were before starting treatment with the medication. You might experience trouble breathing, dizziness, and weakness even with short interruptions in treatment. Talk to your provider before you change your dose or stop taking this medication.

                    dosage

                    Veletri (epoprostenol) dosage forms

                    Typical dosing for Veletri (epoprostenol)

                    Veletri (epoprostenol) is an intravenous (IV) infusion that's given through a pump programmed to deliver your dose over a certain period of time. Before starting Veletri (epoprostenol), your provider will typically insert a catheter into a large vein near the heart. Your care team will train you on how to use the pump at home.

                    • Your provider will calculate the dose based on your body weight. The typical starting dose is 2 nanograms (ng) per kg of body weight per minute (2 ng/kg/min). The dose can be adjusted by your provider based on your response to the medication.

                    interactions

                    Interactions between Veletri (epoprostenol) and other drugs

                    Veletri (epoprostenol) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Veletri (epoprostenol). Please note that only the generic name of each medication is listed below.

                    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                    contraindications-icon

                    Veletri (epoprostenol) contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Veletri (epoprostenol) will not be safe for you to take.
                    alternatives

                    What are alternatives to Veletri (epoprostenol)?

                    There are a number of medications that your doctor can prescribe in place of Veletri (epoprostenol). Compare a few possible alternatives below.

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                    References

                    Best studies we found

                    Actelion Pharmaceuticals US, Inc. (2022). Veletri- epoprostenol injection, powder, lyophilized, for solution [package insert]. DailyMed.

                    Actelion Pharmaceuticals US, Inc. (2023). Taking Veletri®.

                    Actelion Pharmaceuticals US Inc. (2023). A step-by-step programming guide.

                    View All References (12)

                    American Lung Association. (2023). Learn about pulmonary arterial hypertension.

                    Collier, T. E., et al. (2019). Inhaled epoprostenol utilization pattern after implementation of an administration policy. Baylor University Medical Center Proceedings.

                    Gomberb-Maitland, M., et al. (2005). Transition from intravenous epoprostenol to intravenous treprostinil in pulmonary hypertension. American Journal of Respiratory and Critical Care Medicine.

                    Hansen, L., et al. (2018). Volume management in pulmonary arterial hypertension patients: An expert pulmonary hypertension clinician perspective. Pulmonary Therapy.

                    Mitchell, J. A., et al. (2014). Role of prostacyclin in pulmonary hypertension. Global Cardiology Science & Practice

                    Mohammadi, A., et al. (2021). Use of epoprostenol in the treatment of pulmonary arterial hypertension. Cureus.

                    National Cancer Institute. (n.d.). Platelet.

                    Pulmonary Hypertension Association. (2023). Epoprostenol.

                    Ramanlal, R., et al. (2023). Physiology, vasodilation. StatPearls.

                    Ruan, C. H., et al. (2010). Prostacyclin therapy for pulmonary arterial hypertension. Texas Heart Institute Journal.

                    Torbic, H., et al. (2013). Inhaled epoprostenol vs inhaled nitric oxide for refractory hypoxemia in critically ill patients. Journal of Critical Care.

                    U.S. Food and Drug Administration. (2018). Infusion pumps.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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