Epoprostenol
Epoprostenol is an intravenous prostacyclin vasodilator used to treat pulmonary arterial hypertension (PAH), helping patients breathe easier and exercise more.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 4 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Epoprostenol: Patient Information Guide
A plain-language walkthrough of Epoprostenol — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Epoprostenol is an intravenous prostacyclin vasodilator approved to treat pulmonary arterial hypertension (PAH). Here are the supported uses based on available products:
- Epoprostenol for injection (generic) — treats pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity, studied mainly in patients with moderate-to-severe symptoms (NYHA Class III–IV) and idiopathic, heritable, or connective-tissue-disease-associated PAH
- Veletri (intravenous injection) — treats pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity, in the same patient populations including those with PAH linked to connective tissue diseases
⚙️How it works▾
Epoprostenol is a synthetic version of prostacyclin, a natural compound the body makes to relax blood vessels. It works by directly widening (dilating) the arteries in the lungs and throughout the body, which lowers the pressure the right side of the heart has to work against. It also prevents platelets (small blood cells) from clumping together, which helps keep blood flowing more freely.
By reducing the resistance in the lung's blood vessels, epoprostenol makes it easier for the heart to pump blood through the lungs, improving the amount of oxygen-rich blood that reaches the rest of the body — and ultimately helping patients do more physical activity with less effort.
💊How it's taken▾
Epoprostenol is given as a continuous, around-the-clock intravenous infusion — it never stops running. For long-term use, it is delivered through a permanent central venous catheter (a tube in a large vein near the heart) connected to a small, wearable ambulatory infusion pump.
- Treatment is started at a low rate and increased gradually by the care team based on how you respond and any side effects
- Dose increases and decreases must be made slowly — abrupt changes are dangerous
- The infusion solution must be prepared carefully according to specific reconstitution instructions; it cannot be mixed with other IV medications
- Always follow your prescriber's instructions for the infusion rate — never adjust it on your own
🤒Side effects — in detail▾
Side effects are common with epoprostenol and may happen during the initial dose-finding period or during long-term use:
- During dose initiation: flushing, headache, nausea and vomiting, low blood pressure (hypotension), dizziness, chest pain, anxiety, slow heartbeat (bradycardia), fast heartbeat (tachycardia), abdominal pain, muscle pain, shortness of breath
- During long-term use: jaw pain, headache, flushing, diarrhea, nausea and vomiting, flu-like symptoms, anxiety or nervousness, low blood pressure, rash
- Catheter-related: local infection or pain at the catheter site; serious bloodstream infection (sepsis) with long-term use
Contact your doctor right away if you experience serious bleeding, signs of infection (fever, chills, redness at the catheter site), sudden worsening shortness of breath, fainting, or any sign the infusion has stopped or been interrupted.
⚠️Warnings & precautions▾
- Never stop abruptly: Sudden interruption or large dose reductions can cause a life-threatening rebound spike in lung blood pressure — symptoms include sudden shortness of breath, dizziness, and extreme weakness. One patient death in clinical trials was linked to an infusion interruption.
- Infection risk: The permanent central venous catheter required for long-term use carries a real risk of serious bloodstream infection (sepsis). Strict sterile technique when preparing the infusion and caring for the catheter is critical.
- Dose initiation must be monitored: Starting epoprostenol should happen in a setting equipped for close monitoring and emergency care; the team will watch blood pressure and heart rate carefully as the dose is adjusted.
- Blood clot risk: Most patients on epoprostenol are also prescribed a blood thinner (anticoagulant) to reduce the risk of clots traveling to the lungs or through a heart defect — unless there is a specific reason to avoid it.
- High output cardiac failure: Post-marketing reports have identified high output cardiac failure as a potential concern; if symptoms worsen, the dose may need to be reduced.
🔀What it interacts with▾
Epoprostenol can interact with several types of medications, so it is important to tell your care team everything you take:
- Blood pressure-lowering drugs (antihypertensives, diuretics, other vasodilators) — combining these with epoprostenol can cause an extra or excessive drop in blood pressure
- Blood thinners and antiplatelet agents (e.g., warfarin, heparin, aspirin, clopidogrel) — epoprostenol increases the risk of bleeding when used alongside these; monitor closely
- Digoxin — epoprostenol can raise digoxin blood levels, which may be dangerous in patients who are sensitive to digoxin toxicity; levels should be monitored
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Do not use if you have congestive heart failure caused by severe left ventricular systolic dysfunction (the main pumping chamber is too weak) — a large clinical trial showed higher mortality with epoprostenol in this group
- Do not use if you developed pulmonary edema (fluid in the lungs) when the drug was first started
- Do not use if you have a known allergy to epoprostenol or closely related compounds
- Pregnancy: Untreated PAH in pregnancy carries serious risks including heart failure, stroke, preterm delivery, and death for mother and baby; discuss risks and benefits carefully with your doctor
- Breastfeeding: It is unknown whether epoprostenol passes into breast milk; weigh the benefits of breastfeeding against the risks with your doctor
- Children: Safety and effectiveness have not been established in pediatric patients
- Older adults: Use with caution; start at lower doses since older patients may have reduced heart, liver, or kidney function or take multiple other medications
- Lifestyle readiness: Long-term therapy requires managing a permanent IV catheter and portable pump at home — discuss honestly with your team whether this is something you can manage
🚑If you take too much▾
Too much epoprostenol causes an exaggerated version of its normal effects: flushing, severe headache, very low blood pressure, fast heartbeat, nausea, vomiting, and diarrhea. In serious cases, overdose has led to unconsciousness, dangerously low oxygen levels, and respiratory arrest. If you suspect an overdose or the pump delivers too much medication, seek emergency medical help immediately — the usual response is to reduce or stop the infusion rate right away.
📡Pharmacodynamics — effects in the body▾
Epoprostenol lowers the resistance in the blood vessels of the lungs and the rest of the body, reducing the workload on both sides of the heart and increasing how much blood the heart pumps per beat (cardiac output and stroke volume). At lower doses it can slow the heart rate slightly, while at higher doses it may cause the heart rate to rise as a reflex response to the drop in blood pressure. It also prevents platelets from clumping, which helps keep blood flowing freely through narrowed vessels.
🔬Pharmacokinetics — how your body processes it▾
Epoprostenol breaks down extremely quickly in the bloodstream — its half-life (the time for half the drug to be cleared) in human blood is no more than about 6 minutes, which is why the infusion must run continuously without interruption. It is broken down both by the blood's natural chemistry and by enzymes, producing two main metabolites that have far less activity than the original drug. The breakdown products are eliminated mainly through the urine. Because the drug clears so rapidly, stopping the infusion — even briefly — causes drug levels to fall almost immediately.
📦How to store it▾
Unopened vials of VELETRI are stable until the date indicated on the package when stored at 68° to 77°F (20° to 25°C).
📄 Written from Epoprostenol’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
Supplements & herbs that interact with Epoprostenol
136 supplements and herbal products have documented interactions with Epoprostenol in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 4
- Moderate · 111
- Minor · 21
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Nutrient depletion considerations
Epoprostenol has been associated with lower levels of 1 nutrient in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.
Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Epoprostenol — the kind of thing our pharmacy team would talk through with you at the counter.
Why do I have to be on a continuous IV infusion — can't I just take a pill? ▾
What happens if my pump stops or the tubing gets disconnected? ▾
What side effects should I expect, and which ones mean I need to call my doctor? ▾
I'm on a blood thinner — is it safe to use epoprostenol too? ▾
Is it safe to use this medication if I'm pregnant or planning to become pregnant? ▾
Can I ever stop taking this medication if I start feeling better? ▾
Is Epoprostenol available over the counter? ▾
When was Epoprostenol first available? ▾
Who makes Epoprostenol? ▾
💬 Answers drafted from Epoprostenol’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Epoprostenol comes
Epoprostenol is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Injection
How this form is used
- Epoprostenol (generic) injection is used to treat pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity
- Veletri injection is indicated for pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity
- Clinical studies for both products focused on patients with moderate-to-severe PAH (NYHA Class III–IV) with idiopathic, heritable, or connective-tissue-disease-related PAH
- Veletri must be reconstituted only with Sterile Water for Injection or Sodium Chloride 0.9% Injection — do not mix with any other solutions or medications
- Epoprostenol for injection must be reconstituted only with Sterile Water for Injection or Sodium Chloride 0.9% Injection — do not mix with other parenteral solutions
- Both Veletri and Epoprostenol for injection are given as a continuous intravenous infusion through a central venous catheter via an ambulatory infusion pump
- Never stop or abruptly reduce the infusion rate of either product without a physician's direction — dose changes must be made gradually
📊 Epoprostenol across the U.S. market
How Epoprostenol appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Also listed with the FDA, not a patient dose form: Powder (6) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Epoprostenol is used
A general measure of how commonly Epoprostenol is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Epoprostenol is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Epoprostenol prescribed? Of the 1,596 medications we measure, Epoprostenol ranks #1,248 by Medicaid prescriptions — more than 22% of them.
Utilization by Epoprostenol product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
epoprostenol 1.5 MG Injection
Summed across the 2 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 562502
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Epoprostenol, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 6 listed Epoprostenol NDCs with Medicaid activity.
🔍 Compare Epoprostenol products
A representative set of FDA-listed product records for Epoprostenol — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Injection | ||||
| 0.5 mg/10 mL | Intravenous | Actelion Pharmaceuticals US, Inc. × 2 listings | NDA | View NDC → |
| 1.5 mg/10 mL | Intravenous | Actelion Pharmaceuticals US, Inc. × 2 listings | NDA | View NDC → |
| 0.5 mg/10 mL | Intravenous | Gland Pharma Limited | ANDA | View NDC → |
| 1.5 mg/10 mL | Intravenous | Gland Pharma Limited | ANDA | View NDC → |
| 0.5 mg | Intravenous | GlaxoSmithKline LLC × 2 listings | NDA | View NDC → |
| 1.5 mg | Intravenous | GlaxoSmithKline LLC × 2 listings | NDA | View NDC → |
| 0.5 mg/10 mL | Intravenous | Mylan Institutional LLC | ANDA | View NDC → |
| 1.5 mg/10 mL | Intravenous | Mylan Institutional LLC | ANDA | View NDC → |
| 0.5 mg/10 mL | Intravenous | Sun Pharmaceutical Industries, Inc. × 2 listings | ANDA | View NDC → |
| 1.5 mg/10 mL | Intravenous | Sun Pharmaceutical Industries, Inc. × 2 listings | ANDA | View NDC → |
| 0.5 mg | Intravenous | Teva Parenteral Medicines, Inc. | ANDA | View NDC → |
| 1.5 mg | Intravenous | Teva Parenteral Medicines, Inc. | ANDA | View NDC → |
| 1.5 mg/10 mL | — | Wasserburger Arzneimittelwerk GmbH | DRUG FOR FURTHER PROCESSING | View NDC → |
| 💊Bulk drug substance | ||||
| 1 g/g | — | Cayman Pharma s r.o. | BULK INGREDIENT | View NDC → |
| 1 g/g | — | Chirogate International Inc | BULK INGREDIENT | View NDC → |
| 1 g/g | — | EUROAPI Hungary Ltd. | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | MSN Laboratories Private Limited | BULK INGREDIENT | View NDC → |
| 1 g/g | — | Pharmacia and Upjohn Company LLC | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Sun Pharmaceutical Industries, Inc. | BULK INGREDIENT | View NDC → |
Showing 25 of 25 products — FDA National Drug Code Directory. See every product, package size and price: browse all 25 Epoprostenol NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Epoprostenol — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Epoprostenol in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Epoprostenol went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 8814 1 dose form · 2 strengths
-
Dose form (SCDF) Injection RxCUI 1789858In current FDA listings
Look up RxCUI 8814 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Epoprostenol is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Epoprostenol belongs to the Prostacycline Vasodilator class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 4 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Actelion Pharmaceuticals US, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.