iloprost trometamol at a glance
Medicine class
Synthetic prostacyclin analogue and platelet-aggregation inhibitor
Licensed roles
Primary pulmonary hypertension, severe Raynaud’s phenomenon with progressive tissue damage, and selected severe lower-limb ischaemia
How it is given
By an approved nebuliser or as a diluted intravenous infusion, depending on the product and condition
Key practical risks
Low blood pressure, fainting and bleeding require particular attention
What is iloprost trometamol used for?
Licensed uses depend on the formulation and route.
Inhaled formulation: primary pulmonary hypertension in adults with NYHA functional class III symptoms, to improve symptoms and exercise capacity.
Infusion formulation: severe chronic lower-limb ischaemia with risk of amputation when revascularisation or angioplasty has failed or is unsuitable following interdisciplinary review.
Infusion formulation: severe Raynaud’s phenomenon with progressive trophic tissue disorders.
Specialist non-licensed context: some NHS specialist services use intravenous iloprost for scleroderma-related digital ischaemia and digital ulcers.
How does iloprost trometamol work?
Iloprost mimics prostacyclin, a natural signalling substance. It relaxes small arteries and veins, improves blood flow and limits platelet adhesion and aggregation. Inhaled treatment acts preferentially on the pulmonary circulation; intravenous treatment acts systemically.
iloprost trometamol preparations and strengths
Inhaled preparation
Route: Inhaled
Strengths: 10 micrograms/mL, 20 micrograms/mL
Solution for infusion
Route: Intravenous
Strengths: 20 micrograms, 100 micrograms, 100 micrograms/mL
How to take iloprost trometamol
Use only by the route and device specified by the specialist team.
For inhalation, use a compatible prescribed nebuliser and follow its instructions; do not switch devices without clinical supervision.
Transfer the ampoule contents into the nebuliser immediately before use, use a mouthpiece rather than a face mask, and keep the room well ventilated.
Discard solution left in the nebuliser after inhalation and clean the equipment as instructed.
The infusion concentrate is not ready to use. Healthcare professionals must dilute and administer it in a hospital or suitably equipped clinic.
Avoid skin, eye and mouth contact with either solution; promptly wash exposed skin with plenty of water.
iloprost trometamol side effects
Common or expected effects
- Headache, flushing or feeling hot
- Nausea or vomiting
- Dizziness or low blood pressure
- Cough, throat irritation or chest discomfort with inhaled treatment
- Jaw pain
- Sweating with intravenous treatment
- Infusion-site redness, pain or inflammation
Get urgent medical advice
- Bleeding, including coughing up blood or, rarely, bleeding within the skull
- Severe low blood pressure or fainting
- Bronchospasm, wheezing or marked breathing difficulty
- Chest pain, heart attack or serious rhythm disturbance
- Stroke-like symptoms or seizure
- Pulmonary oedema or worsening heart failure
- Severe allergic reaction
iloprost trometamol in pregnancy
Pregnancy requires urgent specialist discussion. The selected infusion product is contraindicated during pregnancy, and pregnancy should be excluded before treatment. Inhaled treatment may be considered only after careful multidisciplinary assessment of maternal benefit and fetal risk because pulmonary hypertension in pregnancy is itself very high risk.
iloprost trometamol while breastfeeding
The selected infusion product is contraindicated while breastfeeding. With inhaled iloprost, transfer into human milk is unknown and risk to the child cannot be excluded, so breastfeeding is preferably avoided. A specialist should assess the formulation, maternal need and feeding options.
iloprost trometamol interactions
The main clinically important interactions involve additive reductions in blood pressure or increased bleeding.
Antihypertensives and vasodilators
Beta-blockers, calcium-channel blockers, ACE inhibitors and other vasodilators may increase dizziness, low blood pressure or fainting.
Anticoagulants
Warfarin-type medicines, direct oral anticoagulants and heparins may increase bleeding risk.
Common questions about iloprost trometamol
Answers are fully visible for fast scanning and source review.
Are iloprost trometamol and iloprost the same thing?
Iloprost is the active therapeutic substance; iloprost trometamol is the salt form used in these preparations to provide it.
Can any nebuliser be used?
No. Use only compatible devices specified for the product. Changing nebulisers requires supervision because delivery characteristics differ.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.