Last update Sept. 4, 2021

Epoprostenol

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Epoprostenol or prostacyclin is a prostaglandin with strong vasodilator and antithrombotic properties which works by inhibiting platelet aggregation. Prostacyclin is the natural prostaglandin that exists in the body and is also present in breast milk.
Indicated in the treatment of pulmonary arterial hypertension and in dialysis when heparin is contraindicated.
Administration by intravenous infusion.

At the date of the last update, there was no available published data on its excretion in breast milk.

Its acid pKa and large volume of distribution, as well as its very fast elimination half-life (T½ of 6 minutes) make it unlikely to pass into breast milk.
Its low oral bioavailability makes it difficult for the infant to pass into plasma from ingested breast milk.

It is a medication that is used in newborns, including premature (Berger 2019).

Prostaglandins in breast milk are synthesized in the mammary gland and are not dependent on plasma levels (Friedman 1986).
Plasma levels of prostacyclin decrease during breastfeeding and return to their normal level after breastfeeding (Ylikorkala 1981).

Alternatives

We do not have alternatives for Epoprostenol.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Epoprostenol is also known as


Epoprostenol in other languages or writings:

Group

Epoprostenol belongs to this group or family:

Tradenames

Main tradenames from several countries containing Epoprostenol in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 353 daltons
VD 0.36 l/Kg
pKa 4.43 -
T½ 0.1 hours

References

  1. Berger-Caron F, Piedboeuf B, Morissette G, Simonyan D, Chétaille P, Pellerin A, Hébert A. Inhaled Epoprostenol for Pulmonary Hypertension Treatment in Neonates: A 12-Year Experience. Am J Perinatol. 2019 Sep;36(11):1142-1149. Abstract
  2. MSC-GSK. Epoprostenol (Flolan) Ficha técnica. 2018 Full text (in our servers)
  3. FDA-Actelion. Epoprostenol (Veleri). Drug Summary. 2012 Full text (in our servers)
  4. Friedman Z. Prostaglandins in breast milk. Endocrinol Exp. 1986 Aug;20(2-3):285-91. Abstract
  5. Ylikorkala O, Viinikka L. Prostacyclin, thromboxane, and prostaglandin F2 alpha in maternal plasma during breast-feeding. Am J Obstet Gynecol. 1981 Mar 15;139(6):690-2. Abstract

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