First inhaled prostacyclin approved for pulmonary arterial hypertension
Safety. Iloprost may cause dizziness, lightheadedness, and syncope due to its blood pressure-lowering effects. Because of this, patients should be monitored while initiating iloprost, and caution should be exercised in patients with low systemic blood pressure to avoid further hypotension. Iloprost has the potential to increase the hypotensive effect of other vasodilators and antihypertensive agents. A potential increased risk of bleeding may be associated with iloprost since the drug inhibits platelet function. This risk may be increased further in patients maintained on anticoagulant therapy. Patients with systolic blood pressure lower than 85 mmHg should not take iloprost. If signs of pulmonary edema occur when iloprost is administered, therapy should be discontinued immediately. Iloprost has not been evaluated in patients with chronic obstructive pulmonary disease (COPD), severe asthma, or acute pulmonary infections. The most common adverse events associated with iloprost include vasodilation (flushing), increased cough, headache, trismus, insomnia, nausea, hypotension, and vomiting.