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Ventavis

iloprost
Used for Pulmonary Hypertension
Used for Pulmonary Hypertension

Iloprost (Ventavis) is an inhalation solution that's used to treat adults who have high blood pressure in the lungs (pulmonary arterial hypertension or PAH). This medication works like the chemical prostacyclin. It opens up the blood vessels leading to the lungs to help your body get more oxygen. Common side effects of iloprost (Ventavis) include cough, dizziness, and headache. Iloprost (Ventavis) is inhaled through the mouth using a special device called the I-neb Adaptive Aerosol Delivery (AAD) system. This system is currently discontinued by Philips Respironics, so you might need to speak with your provider for other options.

Last reviewed on January 1, 2024
basics-icon

What is Iloprost (Ventavis)?

What is Iloprost (Ventavis) used for?

  • Pulmonary arterial hypertension (PAH)

How Iloprost (Ventavis) works

Iloprost (Ventavis) is a lab-made medication that works similarly to the prostacyclin chemical that your body naturally makes. When it's inhaled through the mouth, iloprost (Ventavis) helps to relax the blood vessels in the lungs, which allows more blood to flow through. As a result, the medication helps your body get more oxygen. This helps you breathe and exercise easier.

Drug Facts

Common BrandsVentavis
Drug ClassProstacyclin
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Iloprost (Ventavis)?

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

  • More coughing (39%)
  • Headache (30%)
  • Flushing (27%)
  • Flu symptoms (14%)
  • Nausea (13%)
  • Lockjaw (12%)

Other Side Effects

  • Vomiting
  • Back pain
  • Tongue pain
  • Chest palpitations
  • Muscle cramps
  • Coughing up blood
  • Nosebleeds
  • Trouble sleeping

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Bronchospasm (sudden breathing problems): tightening of the throat, tightness in the chest, trouble breathing, wheezing, cough
  • Chest pain
  • Extremely low blood pressure: dizziness, fainting
  • Symptoms of heart failure: shortness of breath, swelling in the legs and belly

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:

Incidence not known

Black, tarry stools

chest pain

cough

difficult or labored breathing

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

extreme fatigue

fast, pounding, or irregular heartbeat or pulse

fever

hives, itching, or rash

irregular breathing

noisy breathing

pinpoint red spots on the skin

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

tightness in the chest

troubled breathing or swallowing

unusual bleeding or bruising

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

Back pain

chills

cough increased

coughing or spitting up blood

difficulty opening the mouth

feeling of warmth

headache

lockjaw

nausea

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

sweating

trouble sleeping

Less common

Change in taste

mouth irritation

tongue irritation or pain

Incidence not known

Nosebleeds

stuffy nose

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 Iloprost (Ventavis)

thumbs-up

Pros

Medication is inhaled through the mouth and directly into the lungs

Improves the ability to walk or exercise

Lowers the risk of worsening symptoms of PAH

Dose can be adjusted by your provider if needed

thumbs-down

Cons

Need to use 6 to 9 times a day

Not approved for children under 18 years old

Not recommended while breastfeeding

Must use with I-neb AAD system, which is currently discontinued, so might need a different treatment plan

pharmacist-tips

Pharmacist tips for Iloprost (Ventavis)

pharmacist
  • Iloprost (Ventavis) should only be inhaled through the mouth using the I-neb AAD system. Never swallow the medication, and rinse the solution off right away if it touches your skin or eyes.

    • Review the instructions with your provider before you start treatment so that you use iloprost (Ventavis) properly. This medication is available in two different concentrations, so make sure you're using the correct dose, especially if you've recently switched doses. Ask your provider if you have any questions.

      • You can take iloprost (Ventavis) up to every 2 hours. Don't use this medication any sooner even if you have symptoms of PAH (e.g., shortness of breath, fatigue). Discuss with your provider about a treatment schedule that works best for you.

        • Iloprost (Ventavis) can make you feel dizzy or lightheaded. Stand up slowly when you get up from chairs or from bed. Don't drive a car or operate machinery after using this medication and if you feel dizzy.

          • Iloprost (Ventavis) can cause your blood pressure to drop. It's important to regularly check your blood pressure during treatment. Tell your provider if your blood pressure is unusually low.

            • Iloprost (Ventavis) can raise your risk of bleeding. Talk to your provider if you have a history of bleeding problems or if you take blood thinners, such as warfarin (Coumadin).

              • How to open the iloprost (Ventavis) ampule: Insert the ampule into the ampule breaker by matching the blue dot on the ampule to the dot on the breaker. Gently push the breaker away from the dot on the ampule to break the neck of the ampule. Another option is to wrap a rubber pad around the ampule, hold it with the blue dot facing away from you, and snap the neck of the ampule with your thumb.

                • How to set up the I-neb AAD system for iloprost (Ventavis): Use the small pipette to draw up the entire contents of an ampule and empty it into the center of the I-neb system medication chamber. The amount of medication you'll inhale is controlled by either the dosing disc or the medication chamber, which are differentiated by their colors.

                  • How to use the I-neb AAD system to take iloprost (Ventavis): Put the lid back on the I-neb AAD system, cover the latch, and attach the mouthpiece. Turn on the I-neb AAD system according to the directions from the manufacturer. Put your mouth around the mouthpiece and take slow and steady breaths. Each treatment session can last between 4 and 10 minutes.

                    • Throw away any leftover medication in the medication chamber after each treatment with iloprost (Ventavis). Also throw away the top of the ampule and the open ampule in a safe container to avoid accidental injury from broken glass.

                      faqs

                      Frequently asked questions about Iloprost (Ventavis)

                      How is iloprost (Ventavis) administered?
                      Iloprost (Ventavis) is a medication that's inhaled through the mouth using long and slow breaths. The medication itself is a liquid solution that's put into the I-neb Adaptive Aerosol Delivery (AAD) system. This system turns the solution into a mist when you take breaths in using the mouthpiece, which helps you get the correct dose of medication for each treatment. Don't use iloprost (Ventavis) with other systems, such as a nebulizer. This can cause you to inhale the wrong amount of medication, which can affect how well iloprost (Ventavis) works for PAH or raise your risk of side effects. Ask your provider if you have questions about how to use iloprost (Ventavis).
                      How long does it take for iloprost (Ventavis) to work?
                      According to a clinical study, people who used iloprost (Ventavis) for about 3 months were able to walk an average of about 130 feet farther than people who used placebo during a 6-minute time frame. This was measured 30 minutes after inhaling a dose of iloprost (Ventavis).
                      How long does iloprost (Ventavis) last?
                      How long the effects of iloprost (Ventavis) last can depend on your health conditions and genetics, so it can be different for each individual person. It could last up to about 2 hours after a treatment for some, but not for others. This time frame is estimated based on the half-life of this medication. Keep in mind that iloprost (Ventavis) should only be used every 2 hours and no sooner. Let your provider know if you experience trouble breathing before your next treatment.
                      What precautions should be taken when using iloprost (Ventavis)?
                      Iloprost (Ventavis) might suddenly lower your blood pressure, which can cause dizziness and lightheadedness. It's important to regularly check your blood pressure during treatment. Get up slowly from a sitting or lying down position after you use the medication so you don't feel dizzy or fall. Also, don't drive a car or operate machinery until you know how iloprost (Ventavis) affects you. Tell your provider if you faint or feel dizzy while you're using this medication.
                      Is iloprost (Ventavis) FDA approved?
                      Yes. The FDA approved iloprost (Ventavis) in 2004 to help treat pulmonary arterial hypertension (PAH) in adults.
                      What is iloprost (Ventavis) infusion?
                      Iloprost (Ventavis) is an inhalation solution that's used for PAH. Some studies suggest that other formulations of the active ingredient, iloprost, can be given intravenously (into the veins) as an infusion for people with Raynaud's phenomenon. Keep in mind that the currently FDA-approved formulation of iloprost is the inhalation solution that's meant to be used to treat PAH only. Talk to your provider if you're not sure whether iloprost (Ventavis) is right for you.
                      Is iloprost (Ventavis) safe during pregnancy?
                      It isn't clear whether iloprost (Ventavis) is safe to take during pregnancy because there's not enough information available. Keep in mind that PAH during pregnancy can also raise the risk of harm to mothers and babies. Tell your provider if you're considering pregnancy before you start treatment with iloprost (Ventavis). Your provider can help you decide whether the benefits of this medication outweigh the potential risks.
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                      warings-icon

                      What are the risks and warnings for Iloprost (Ventavis)?

                      Iloprost (Ventavis) 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

                      Low blood pressure and risk of fainting

                      • Risk factor: History of low blood pressure

                        Iloprost (Ventavis) can relax your blood vessels throughout your body. This can cause your blood pressure to drop, which can put you at risk for fainting. In addition, fainting can sometimes happen with pulmonary arterial hypertension (PAH), especially if you physically exert yourself.

                        Let your provider know if you have a history of having low blood pressure or if you take other medications to lower your blood pressure. Your provider will check your blood pressure before you start iloprost (Ventavis) to make sure it's safe for you.

                        Don't drive a car or operate machinery right after using iloprost (Ventavis) or if you feel dizzy or lightheaded. Be careful while doing certain activities, such as exercising, which can suddenly lower your blood pressure as well. Let your provider know right away if you experience symptoms such as lightheadedness, dizziness, or fainting.

                        risk-warning

                        Fluid buildup in the lungs

                        Iloprost (Ventavis) is used to treat pulmonary arterial hypertension (PAH), which is different from pulmonary venous hypertension (PVH). Don't use this medication if you've been told that you have PVH since it can worsen your condition. Let your provider know and stop iloprost (Ventavis) right away if you have trouble breathing or wheezing during treatment. These might be signs of fluid buildup in your lungs due to PVH.

                        risk-warning

                        Worsening of breathing

                        • Risk factors: History of breathing problems | Active lung infection

                          Although rare, iloprost (Ventavis) can sometimes tighten the airways, which makes it difficult to breathe. This might be more severe or more likely to happen if you have asthma, chronic obstructive pulmonary disease (COPD), or a lung infection. Stop using iloprost (Ventavis) right away and speak to your healthcare provider if you have more wheezing, shortness of breath, or coughing after using the medication.

                          dosage

                          Iloprost (Ventavis) dosage forms

                          Typical dosing for Iloprost (Ventavis)

                          Iloprost (Ventavis) solution comes in ampules. Each ampule contains 10 mcg or 20 mcg of iloprost. With the I-neb AAD system, a 10 mcg ampule can deliver 2.5 mcg or 5 mcg of iloprost for each treatment session, and a 20 mcg ampule can deliver 5 mcg of iloprost for each treatment session.

                          The typical starting dose is 2.5 mcg inhaled by mouth 6 to 9 times daily, about 2 hours apart. Your provider might raise your dose to 5 mcg inhaled 6 to 9 times daily (no more than once every 2 hours), depending on how well you tolerate the medication. The maximum total dose is 45 mcg daily (5 mcg inhaled 9 times daily).

                          interactions

                          Interactions between Iloprost (Ventavis) and other drugs

                          Iloprost (Ventavis) 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 Iloprost (Ventavis). Please note that only the generic name of each medication is listed below.

                          Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                          • Defibrotide

                          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.

                          alternatives

                          What are alternatives to Iloprost (Ventavis)?

                          There are a number of medications that your doctor can prescribe in place of Iloprost (Ventavis). Compare a few possible alternatives below.
                          Iloprost (Ventavis)
                          Used for:
                          • Pulmonary arterial hypertension (PAH)

                          Used for:

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                          References

                          Best studies we found

                          Actelion Pharmaceuticals US, Inc. (2022). Ventavis- iloprost solution [package insert]. DailyMed.

                          Afify, H., et al. (2022). Pulmonary hypertension in pregnancy: Challenges and solutions. Integrated Blood Pressure Control.

                          American Lung Association. (n.d.). Pulmonary arterial hypertension (PAH).

                          View All References (11)

                          American Lung Association. (n.d.). Pulmonary hypertension.

                          American Society of Health-System Pharmacists. (2024). Iloprost inhalation solution (Ventavis).

                          CoTherix, Inc. (2004). Ventavis (Iloprost) inhalation solution [package insert]. U.S. Food and Drug Administration.

                          Dadfarmay, S., et al. (2010). Differentiating pulmonary arterial and pulmonary venous hypertension and the implications for therapy. Congestive Heart Failure.

                          Laria, A., et al. (2015). User preference for a portable syringe pump for iloprost infusion. Patient Related Outcome Measures.

                          Stitham, J., et al. (2011). Prostacyclin: An inflammatory paradox. Frontiers in Pharmacology.

                          Ventavis. (n.d.). About Ventavis.

                          Ventavis. (n.d.). Breathing technique.

                          Ventavis. (n.d.). How Ventavis helps patients with PAH symptoms (NYHA Class III/IV).

                          Ventavis. (n.d.). Setting up the I-neb AAD System.

                          Ventavis. (n.d.). Taking Ventavis (iloprost) with theI-neb AAD Nebulizer.

                          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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