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Updated February 2025
Iloprost is a prostaglandin analogue or synthetic prostaglandin. Prostaglandins are hormone-like substances found within the body and have many functions. One of the functions is to allow blood vessels to widen.
Iloprost is used to treat conditions like scleroderma and Raynaud’s phenomenon, where blood flow to the fingers is very poor. This can lead to ulcers and, in some cases, gangrene. Iloprost enables the small vessels to widen and allow increased blood flow.
Iloprost is not listed on the Pharmaceutical Benefits Scheme (PBS), but your rheumatologist may be able to obtain approval and prescribe it through the Special Access Scheme.
Iloprost works quickly to improve circulation but can take up to 6 weeks to see the full effect.
Your rheumatologist or treating doctor may choose to stop the iloprost infusion before it’s completed. Speak to your rheumatologist if you have any questions about stopping iloprost.
During an iloprost infusion, your blood pressure, heart rate, and any side effects like nausea or headaches will be closely monitored.
Your rheumatologist will check how you respond over time and together you can decide whether to repeat the infusion. It may be given at the start of winter to reduce the chance of severe circulation problems which are more common with colder weather.
Iloprost is given intravenously. A small needle is inserted into a vein and the medicine is infused. It is given over 6 hours each day for 3-5 days. Some hospitals may also give this medicine over a 24-hour period as an inpatient.
Iloprost is usually given gradually, and the rate of infusion can be changed if side effects occur.
For infusions, the dose is based on the person’s weight, so each person's dose may be different.
Always discuss what medicines you are taking, including any over-the-counter medicines with your doctor.
Iloprost can decrease your blood pressure even more if you are taking blood pressure medicines. If this occurs, it can be managed by slowing down the iloprost infusion or temporarily stopping your blood pressure medicines on the day of your infusion. It is important to talk to your doctor about this.
Iloprost can increase the risk of bleeding by reducing the function of platelets. Patients taking blood thinning agents such as warfarin or other inhibitors of platelet function will need to discuss their use prior to infusion.
You might experience side effects with your treatment. Contact your doctor if you have any concerns about possible side effects.
You will be closely monitored during the infusion for side effects. The iloprost infusion can be slowed or stopped for a period of time if required. Medicines to help with common side effects such as nausea and headache can be given.
Iloprost side effects usually stop quickly once the infusion is stopped.
Common possible side effects include:
Precautions with other diseases
Iloprost infusions may need to be delayed in the following circumstances, but it is best to be discussed between the treating rheumatologist and the patient.
Use with other medicines
Vaccines
More information is available on Vaccinations in Rhematology and COVID-19 vaccination.
Surgery
Use with alcohol
Cancer risk
Use in pregnancy and when breastfeeding