Please note that it has not been updated and that more recent literature may have become available since it was written. Epoprostenol is a metabolite of arachidonic acid which is produced primarily in the vascular endothelium. It is a potent vasodilator of both the pulmonary and systemic arterial and venous beds. However, in patients who are resistant to oral vasodilators, an infusion of epoprostenol has been shown in clinical trials to decrease pulmonary vascular resistance, increase cardiac output, and increase oxygen delivery to tissues. In others, the long-term infusion of epoprostenol has improved symptoms so much that transplantation is no longer required.
Some patients are able to return to work and to their normal lives.
Although epoprostenol has been approved for PPH, it may have a role in secondary forms of pulmonary hypertension. However, the role epoprostenol will play in these conditions remains to be addressed. The adverse effects documented with the use of epoprostenol have ranged from mild to life threatening. The most frequently reported side effects include loose stools, headache, jaw pain, hypotension, flushing, dyspnea, and photosensitivity. Serious adverse effects may occur as a result of abrupt withdrawal of the infusion or large reductions in the dose of epoprostenol.