Ventavis
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.
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
What are the side effects of Iloprost (Ventavis)?
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
- 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:Â 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
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
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:
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 of Iloprost (Ventavis)
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
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 for Iloprost (Ventavis)
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.
Frequently asked questions about Iloprost (Ventavis)
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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.
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.
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.
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.
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 between Iloprost (Ventavis) and other drugs
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.
- Aceclofenac
- Acemetacin
- Amtolmetin Guacil
- Apixaban
- Ardeparin
- Argatroban
- Bemiparin
- Bivalirudin
- Bromfenac
- Bufexamac
- Celecoxib
- Certoparin
- Choline Salicylate
- Citalopram
- Clonixin
- Dabigatran Etexilate
- Dalteparin
- Danaparoid
- Desirudin
- Desvenlafaxine
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Duloxetine
- Edoxaban
- Enoxaparin
- Escitalopram
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Fluoxetine
- Flurbiprofen
- Fluvoxamine
- Fondaparinux
- Heparin
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Lepirudin
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Milnacipran
- Morniflumate
- Nabumetone
- Nadroparin
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Parnaparin
- Paroxetine
- Phenindione
- Phenprocoumon
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Proglumetacin
- Propyphenazone
- Proquazone
- Protein C
- Reviparin
- Rivaroxaban
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sertraline
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tinzaparin
- Tolfenamic Acid
- Tolmetin
- Valdecoxib
- Venlafaxine
- Vilazodone
- Vortioxetine
- Warfarin
What are alternatives to Iloprost (Ventavis)?
Pulmonary arterial hypertension (PAH) in adults
Chronic thromboembolic pulmonary hypertension (CTEPH) in adults
Pulmonary hypertension from severe lung problems
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References
Best studies we foundActelion 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).
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.
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