Iloprost

Iloprost is used to improve the blood flow for people with very bad circulation problems. It works by causing the smaller blood vessels to widen, which allows more blood to flow through them.

Iloprost usually starts to work at once, although it can take up to six weeks to take effect. If you have very cold hands or feet, they may feel warmer straight away. Ulcers may start to get better within a few days. You may feel the benefits of iloprost for several weeks, and sometimes months, after taking it.

By inhaling through a nebuliser

Iloprost can be used to treat high blood pressure in the arteries that supply blood to the lungs. Your doctor may call it pulmonary arterial hypertension and it can affect people who have scleroderma. This is different to the general condition 'high blood pressure'.

You can take iloprost through a nebuliser to treat pulmonary arterial hypertension. Nebulisers will turn the liquid medicine into a mist, which you can breathe in.

If you need to take iloprost in this way, you will need to stay in hospital for a few days. You will be trained to use the nebuliser and your response to the treatment will be monitored. After these few days, you should be able to go home and continue taking the medicine yourself.

Infusion

If iloprost is given by infusion, it will go through a drip, into a vein in your arm. The length of treatment varies, depending on your condition, but the infusion will last for around six hours a day. This will be given in one go. This session will be repeated for three to five days in a row, in hospital or at a clinic.

It can sometimes be given over the course of 24 hours. In some hospitals, you stay on the ward for five days, and in others, you go to the day-case unit during the day and go home in the evening.

The rate at which iloprost is given depends on your weight. If you experience side effects, the rate can be changed.

Before you start using iloprost, it is important to tell your doctor the following information:

• if you are pregnant or breastfeeding
• if you think you may have a chest infection
• if you think you may be at risk of bleeding – for example, if you have recently had an injury or if you have a stomach ulcer
• if you have a heart condition such as a heart valve defect or have angina pain
• if you have recently had a heart attack
• if you have any problems with your breathing, such as asthma or chronic obstructive pulmonary disease (COPD)
• if you have recently had a stroke
• if you have liver problems
• if you are taking or using any other medicines, including herbal and complementary treatments
• if you have ever had an allergic reaction to a medicine.

Common side effects include:

• chest pain
• cough
• diarrhoea
• shortness of breath
• headache
• low blood pressure
• jaw pain
• feeling sick
• scratchy or tickly throat
• a rash
• vomiting.

Try to make sure that iloprost doesn't touch your skin. If this happens, wash the area immediately with plenty of water.

Some drugs may interact with iloprost. Check with your doctor before starting this drug and before starting any other medicines while you're on iloprost.

Iloprost doesn't interact with vaccinations, so you can have them before or after a course of iloprost treatment. If you need to have a vaccination during your iloprost treatment, speak to a healthcare professional.

There's no particular reason to avoid alcohol before or after a course of iloprost treatment. However, drinking a lot of alcohol could make your side effects worse.

Government guidelines say that men and women should have no more than 14 units of alcohol a week, and that you should spread these through the week rather than having them all in one go. You can find out more about units of alcohol at www.drinkaware.co.uk.

Iloprost is not recommended if you're pregnant. If you're planning to start a family, speak to your doctor before starting treatment with iloprost.

There is limited information available on the effects of taking iloprost while breastfeeding. Speak to your doctor if you are breastfeeding or planning to breastfeed while taking iloprost.