Iloprost

Iloprost is used to treat certain kinds of pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Iloprost may improve the ability to exercise and slow the worsening of symptoms in patients with PAH. Iloprost is in a class of medications called vasodilators. It works by relaxing the blood vessels, including those in the lungs.

Iloprost comes as a solution to inhale by mouth. It is usually inhaled six to nine times a day during waking hours. Use iloprost exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor or nurse will show you how to use iloprost inhalation solution with your delivery device. Carefully read the manufacturer's instructions that describe how to prepare and inhale a dose of iloprost. Be sure to ask your pharmacist, doctor, or nurse if you have any questions about how to prepare or inhale this medication. After each dose of medication, dispose of any solution remaining in the delivery device and carefully follow the manufacturer's instructions for cleaning the delivery system components. Do not mix other medications with iloprost solution.

Do not swallow iloprost solution. If iloprost solution gets on your skin or in your eyes, rinse your skin or eyes with water right away. Be careful not to use iloprost inhaler too close to other people, especially pregnant women and infants, so that they do not inhale the medication.

Do not use iloprost inhaler more than once every two hours. Because the effects of the medication may not last 2 hours, you may need to adjust the timing of your doses to cover your planned activities.

Iloprost solution is used with certain inhaler devices. Make sure you can get another delivery device to use right away if your device does not work for any reason.

Iloprost is not available at retail pharmacies. Your medication will be mailed to you from a specialty pharmacy. Ask your doctor if you have any questions about how you will receive your medication.

Iloprost controls PAH but does not cure it. Continue to take iloprost even if you feel well. Do not stop taking iloprost without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient and a copy of the user's guide for the inhaler device.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking iloprost,

• tell your doctor and pharmacist if you are allergic to iloprost, any other medications, or any of the ingredients in iloprost solution. Ask your pharmacist or check the manufacturer's patient information for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (''blood thinners'') such as warfarin (Coumadin); and medications for high blood pressure or other heart problems.
• tell your doctor if you have or have ever had chronic obstructive pulmonary disease (COPD), asthma, low blood pressure, and kidney or liver disease. Also tell your doctor if you have an infection in your lungs.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking iloprost, call your doctor.
• you should know that iloprost may cause dizziness, lightheadedness, or fainting, especially when you get up too quickly from a lying position or during physical effort or exercise. To help avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Do not drive a car or operate tools or machinery until you know how this drug affects you. Tell your doctor if you continue to have fainting while you are receiving iloprost treatment.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Iloprost may cause side effects. Tell your doctor if any of these symptoms or those in the SPECIAL PRECAUTIONS section are severe or do not go away:

• flushing
• cough
• blurred vision
• nausea
• vomiting
• headache
• tightening of jaw muscles that makes it hard to open your mouth
• difficulty falling asleep or staying asleep
• tongue pain

Some side effects can be serious. If you experience any of these symptoms, stop taking iloprost and get emergency medical treatment:

• difficulty breathing
• bubbly, wheezing, or gasping sound when you breathe
• coughing up pink, frothy sputum
• grey-bluish color of lips or skin

Iloprost may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• fainting
• dizziness
• blurred vision
• nausea
• vomiting
• diarrhea
• headache
• flushing

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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