How does this medication work? What will it do for me?

Alprostadil, also known as prostaglandin E1, belongs to a class of medications known as vasodilators. It is used to treat babies with certain types of congenital heart defects. It keeps the ductus arteriosus (a passageway in the heart) open until surgery can be done.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why your baby is being given this medication, speak to your doctor.

What form(s) does this medication come in?

Alprostadil injection by Valeo Pharma is no longer being manufactured for sale in Canada. For brands that may still be available, search under alprostadil. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The recommended initial dosage of alprostadil is calculated by your doctor based on body weight. When the desired effect on the ductus arteriosus (a passageway in your baby's heart) is achieved, the infusion rate is usually decreased to the lowest possible dose while still maintaining the desired effect on the ductus arteriosus.

Alprostadil is usually given through a continuous intravenous infusion into a vein by a health care professional in a hospital setting. It can also be given into an artery at the opening of the ductus arteriosus.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. Your doctor may have recommended a different dose from the one listed here.

Store this medication in the refrigerator at 2°C to 8°C. Once the medication has been prepared by dilution, it must be used within 24 hours, after which it must be discarded. Protect from light and keep out of reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Alprostadil should not be used by anyone who:

  • is allergic to alprostadil or to any of the ingredients of the medication
  • has certain heart or lung conditions which, in their doctor's judgment, would make it dangerous for them to use this medication

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your baby's doctor.

While your baby is receiving alprostadil, health care professionals in the hospital will be monitoring your baby for any possible side effects. The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if your baby experiences these side effects and they are severe or bothersome.

  • apnea (episodes of regular breathing with pauses)
  • diarrhea
  • fever
  • flushing
  • infections
  • low blood pressure (symptoms include dizziness or fainting)
  • slow or fast heartbeat
  • spitting up
  • swelling of the arms, feet, or legs

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your baby's doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal heart rhythm
  • blood clots
  • blood in urine
  • bluish skin colour
  • convulsions or seizures
  • feeling drowsy or sluggish
  • hypothermia (abnormally low body temperature; e.g., shivering, shallow breathing, drowsiness, loss of consciousness)
  • inability of the kidneys to produce urine
  • irritability or jitteriness
  • low blood sugar levels (e.g., dizziness, lack of energy, sweating, or shakiness)
  • low potassium levels (e.g., weakness, muscle cramps, constipation, nausea or vomiting, heart palpitations, increased thirst or urination, tingling or numbness)
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • stiffness
  • symptoms of inflammation around the tonsils (e.g., fever, chills, difficulty opening mouth, swelling of the face and neck)
  • unusually fast breathing
  • yellowing of the skin or whites of the eyes

Stop the medication and seek immediate medical attention if any of the following occur:

  • bleeding in the brain (e.g., sudden, extremely severe headache; decreased coordination)
  • cardiac arrest
  • decreased response to this medication
  • excessive bleeding
  • high pitched whistling while breathing
  • overextension of the neck
  • signs of sepsis (blood infection; e.g., fever, dizziness, chills, very high or very low body temperature, low blood pressure, pounding or rapid heartbeat, rapid or shallow breathing)
  • signs of a serious allergic reaction (e.g., shortness of breath or difficulty breathing; hives; swelling of the eyes, mouth, lips, or throat)
  • signs of shock (e.g., cold, damp skin; confusion; shakiness; nausea; weak, rapid pulse)
  • sudden chest pain and shortness of breath
  • symptoms of too much potassium in the body (e.g., muscle fatigue, weakness, difficulty moving, abnormal heart rhythms, nausea)
  • symptoms of too much carbon dioxide in the blood (e.g., flushed skin, drowsiness, headache, dizziness, shortness of breath, exhaustion)
  • troubled breathing or stopped breathing

Some people may experience side effects other than those listed. Check with your baby's doctor if you notice any symptom that worries you while your baby is on this medication.

Are there any other precautions or warnings for this medication?

Before your baby begins using a medication, be sure to inform your doctor of any medical conditions or allergies your baby may have, any medications your baby is taking, and any other significant facts about your health. These factors may affect how your baby will receive this medication.

Bleeding disorders: If your baby has a bleeding disorder, discuss this with your baby's doctor to see how this medication may affect your baby's medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hospital use: This medication should only be given by a trained health care professional in a hospital setting.

Lung problems: If your baby has any lung problems, discuss this with your baby's doctor to see how this medication may affect your baby's medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Other heart problems: If your baby has other heart problems or low blood pressure, discuss this with your baby's doctor to see how this medication may affect your baby's medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

What other drugs could interact with this medication?

For a full list of interactions, use the Drug Interaction Checker available on the website.

If you are giving your baby other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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