Warning: Medical emergency if infusion interrupted; infuse through dedicated line.

Epoprostenol infusion requires an in-line 0.22 micron filter. See Filter Recommendations for IV Medications

Pulmonary Artery Hypertension: IV Admixture Tip Sheet (Legacy 6/2025)

Epoprostenol may only be ordered via Order Set.  See 900.3233 Medications: Orders

For inhaled epoprostenol - see TIP SHEET for ordering

• Monitoring :
  • Patients’ response to inhaled epoprostenol will be assessed by changes in oxygenation and hemodynamics:
    • Vital signs including blood pressure, heart rate, and oxygen saturations every 15 minutes for one hour during initial treatment and after each dose change, then per ICU protocol.
    • Other objective tools to assess efficacy of inhaled epoprostenol, including but not limited to invasive hemodynamic monitoring (e.g., pulmonary artery pressure monitoring, echocardiography).

• • Patients’ tolerability to inhaled epoprostenol will be assessed by signs and symptoms suggesting toxicity or intolerance:
    • Severe thrombocytopenia and bleeding
    • Worsening hemodynamics
    • Worsening oxygenation 

• Weaning and Discontinuation:
  • Weaning:
    • If weaning is appropriate, decrease rate by half for 30 minutes. If patient tolerated the half-rate, the discontinue therapy.
    • Weaning should be reconsidered and attending physician contacted if a patient demonstrates a decrease in oxygenation within 30 minutes of weaning. 

• • Discontinuation:
    • Provider and treatment team will collaborate to determine if there was a reasonable clinical response (e.g. increase in PaO2/FiO2 of at least 10% or greater, improvements in hemodynamic or oxygenation parameters in response to reduction in pulmonary artery pressures). If no response is noted after 2 hours, inhaled epoprostenol therapy should be discontinued.
    • The half-life of epoprostenol is 3-6 minutes, and effect should be seen within 15 minutes of drug initiation. If there is no clinical effect after 2 to 4 hours, the drug should be discontinued. 

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