Skip to main content
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1982 Aug;14(2):177–185. doi: 10.1111/j.1365-2125.1982.tb01959.x

Side effects occurring during administration of epoprostenol (prostacyclin, PGI2), in man.

H Pickles, J O'Grady
PMCID: PMC1427755  PMID: 7049212

Abstract

1 Fifty infusions of epoprostenol (PGI2) were made, usually increasing the infusion rate until adverse effects were encountered. The volunteers were appraised that they might experience headache and facial flushing. 2 Facial flushing, headache, tachycardia and decrease in diastolic blood pressure were seen in almost all subjects. Erythema over the venous infusing site was also encountered in 13 infusions. Less common effects were sudden bradycardia, pallor and sweating--the vagal reflex--(seven times) and chest pain (twice). Other complaints included restlessness, abdominal discomfort, nausea and drowsiness. 3 The literature on side effects reported during PGI2 infusion is reviewed and recommendations are made concerning administration of PGI2.

Full text

PDF
184

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arze R. S., Ward M. K. Prostacyclin safer than heparin in haemodialysis. Lancet. 1981 Jul 4;2(8236):50–50. doi: 10.1016/s0140-6736(81)90291-9. [DOI] [PubMed] [Google Scholar]
  2. Beattie T. J., Murphy A. V., Willoughby M. L., Belch J. J. Prostacyclin infusion in haemolytic-uraemic syndrome of children. Br Med J (Clin Res Ed) 1981 Aug 15;283(6289):470–470. doi: 10.1136/bmj.283.6289.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Beitner H., Hammar H., Olsson A. G., Thyresson N. Prostaglandin E1 treatment of leg ulcers caused by venous or arterial incompetence. Acta Derm Venereol. 1980;60(5):425–430. doi: 10.2340/0001555560425430. [DOI] [PubMed] [Google Scholar]
  4. Belch J. J., Newman P., Drury J. K., Capell H., Leiberman P., James W. B., Forbes C. D., Prentice C. R. Successful treatment of Raynaud's Syndrome with prostacyclin. Thromb Haemost. 1981 Jun 30;45(3):255–256. [PubMed] [Google Scholar]
  5. Bergman G., Daly K., Atkinson L., Rothman M., Richardson P. J., Jackson G., Jewitt D. E. Prostacyclin: haemodynamic and metabolic effects in patients with coronary artery disease. Lancet. 1981 Mar 14;1(8220 Pt 1):569–572. doi: 10.1016/s0140-6736(81)92028-6. [DOI] [PubMed] [Google Scholar]
  6. Bianco S., Robuschi M., Ceserani R., Gandolfi C. Effects of prostacyclin on aspecifically and specifically induced bronchoconstriction in asthmatic patients. Eur J Respir Dis Suppl. 1980;106:81–87. [PubMed] [Google Scholar]
  7. Budd G. T., Bukowski R. M., Lucas F. V., Cato A. E., Cocchetto D. M. Prostacyclin therapy of thrombotic thrombocytopenic purpura. Lancet. 1980 Oct 25;2(8200):915–915. doi: 10.1016/s0140-6736(80)92071-1. [DOI] [PubMed] [Google Scholar]
  8. Chapple D. J., Dusting G. J., Hughes R., Vane J. R. Some direct and reflex cardiovascular actions of prostacyclin (PGI2) and prostaglandin E2 in anaesthetized dogs. Br J Pharmacol. 1980 Mar;68(3):437–447. doi: 10.1111/j.1476-5381.1980.tb14557.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Christ-Hazelhof E., Nugteren D. H. Prostacyclin is not a circulating hormone. Prostaglandins. 1981 Nov;22(5):739–746. doi: 10.1016/0090-6980(81)90213-6. [DOI] [PubMed] [Google Scholar]
  10. Data J. L., Molony B. A., Meinzinger M. M., Gorman R. R. Intravenous infusion of prostacyclin sodium in man: clinical effects and influence on platelet adenosine diphosphate sensitivity and adenosine 3':5'-cyclic monophosphate levels. Circulation. 1981 Jul;64(1):4–12. doi: 10.1161/01.cir.64.1.4. [DOI] [PubMed] [Google Scholar]
  11. Dembińska-Kieć A., Kostka-Trabka E., Grodzińska L., Zmuda A., Bieroń K., Kedzior A., Ochmański W., Zelazny T. Prostacyclin and blood glucose levels in humans and rabbits. Prostaglandins. 1981 Jan;21(1):113–121. doi: 10.1016/0090-6980(81)90201-x. [DOI] [PubMed] [Google Scholar]
  12. Dowd P. M., Martin M. F., Cooke E. D., Bowcock S. A., Jones R., Dieppe P. A., Kirby J. D. Treatment of Raynaud's phenomenon by intravenous infusion of prostacyclin (PGI2). Br J Dermatol. 1982 Jan;106(1):81–89. doi: 10.1111/j.1365-2133.1982.tb00905.x. [DOI] [PubMed] [Google Scholar]
  13. Federation of American Societies for Experimental Biology. 64th Annual Meeting. Anaheim, California. April 13--18, 1980. Abstracts of papers. 3014--4925. Fed Proc. 1980 Mar 1;39(3 Pt 2):839–1403. [PubMed] [Google Scholar]
  14. Fidler J., Bennett M. J., de Swiet M., Ellis C., Lewis P. J. Treatment of pregnancy hypertension with prostacyclin. Lancet. 1980 Jul 5;2(8184):31–32. doi: 10.1016/s0140-6736(80)92904-9. [DOI] [PubMed] [Google Scholar]
  15. FitzGerald G. A., Friedman L. A., Miyamori I., O'Grady J., Lewis P. J. A double blind placebo controlled crossover study of prostacyclin in man. Life Sci. 1979 Aug 20;25(8):665–672. doi: 10.1016/0024-3205(79)90507-1. [DOI] [PubMed] [Google Scholar]
  16. FitzGerald G. A., Hossmann V., Hummerich W., Konrads A. The renin--kallikrein--prostaglandin system: plasma active and inactive renin and urinary kallikrein during prostacyclin infusion in man. Prostaglandins Med. 1980 Dec;5(6):445–456. doi: 10.1016/0161-4630(80)90068-3. [DOI] [PubMed] [Google Scholar]
  17. Gimson A. E., Langley P. G., Hughes R. D., Canalese J., Mellon P. J., Williams R., Woods H. F., Weston M. J. Prostacyclin to prevent platelet activation during charcoal haemoperfusion in fulminant hepatic failure. Lancet. 1980 Jan 26;1(8161):173–175. doi: 10.1016/s0140-6736(80)90661-3. [DOI] [PubMed] [Google Scholar]
  18. Guadagni D. N., Ikram H., Maslowski A. H. Haemodynamic effects of prostacyclin (PGI2) in pulmonary hypertension. Br Heart J. 1981 Apr;45(4):385–388. doi: 10.1136/hrt.45.4.385. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Hassan S., Macdougall I. C., O'Grady J., Pickles H. Cigarette smoking does not attenuate the cardiovascular effects of epoprostenol (prostacyclin) in humans. Br J Clin Pharmacol. 1982 Jul;14(1):97–98. doi: 10.1111/j.1365-2125.1982.tb04940.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Hensby C. N., Lewis P. J., Hilgard P., Mufti G. J., Hows J., Webster J. Prostacyclin deficiency in thrombotic thrombocytopenic purpura. Lancet. 1979 Oct 6;2(8145):748–748. doi: 10.1016/s0140-6736(79)90680-9. [DOI] [PubMed] [Google Scholar]
  21. Hintze T. H., Panzenbeck M. J., Messina E. J., Kaley G. Prostacyclin (PGI2) lowers heart rate in the conscious dog. Cardiovasc Res. 1981 Sep;15(9):538–546. doi: 10.1093/cvr/15.9.538. [DOI] [PubMed] [Google Scholar]
  22. Karazyn M., Horrobin D. F., Manku M. S., Cunnane S. C., Karmali R. A., Ally A. I., Morgan R. O., Nicolaou K. C., Barnette W. E. Effect of prostacyclin on perfusion pressure, electrical activity, rate and force of contraction in isolated rat and rabbit hearts. Life Sci. 1978 Jun 19;22(23):2079–2085. doi: 10.1016/0024-3205(78)90451-4. [DOI] [PubMed] [Google Scholar]
  23. Lock J. E., Olley P. M., Coceani F., Swyer P. R., Rowe R. D. Use of prostacyclin in persistent fetal circulation. Lancet. 1979 Jun 23;1(8130):1343–1343. doi: 10.1016/s0140-6736(79)91970-6. [DOI] [PubMed] [Google Scholar]
  24. Machin S. J., Chamone D. A., Defreyn G., Vermylen J. The effect of clinical prostacyclin infusions in advanced arterial disease on platelet function and plasma 6-keto PGF1 alpha levels. Br J Haematol. 1981 Mar;47(3):413–422. doi: 10.1111/j.1365-2141.1981.tb02809.x. [DOI] [PubMed] [Google Scholar]
  25. Medbak S., Wass J. A., Clement-Jones V., Cooke E. D., Bowcock S. A., Cudworth A. G., Rees L. H. Chlorpropamide alcohol flush and circulating met-enkephalin: a positive link. Br Med J (Clin Res Ed) 1981 Oct 10;283(6297):937–939. doi: 10.1136/bmj.283.6297.937. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. O'Grady J., Warrington S., Moti M. J., Bunting S., Flower R., Fowle A. S., Higgs E. A., Moncada S. Effects of intravenous infusion of prostacyclin (PGI2) in man. Prostaglandins. 1980 Feb;19(2):319–332. doi: 10.1016/0090-6980(80)90030-1. [DOI] [PubMed] [Google Scholar]
  27. Olsson A. G. Intravenous prostacyclin for ischemic ulcers in peripheral artery disease. Lancet. 1980 Nov 15;2(8203):1076–1076. doi: 10.1016/s0140-6736(80)92290-4. [DOI] [PubMed] [Google Scholar]
  28. Olsson A. G., Nilsson E. The effect of intravenous prostacyclin on resting pains and healing of ischaemic ulcers in peripheral artery disease. Prostaglandins Med. 1981 Apr;6(4):329–339. doi: 10.1016/0161-4630(81)90064-1. [DOI] [PubMed] [Google Scholar]
  29. Pardy B. J., Lewis J. D., Eastcott H. H. Preliminary experience with prostaglandins E1 and I2 in peripheral vascular disease. Surgery. 1980 Dec;88(6):826–832. [PubMed] [Google Scholar]
  30. Patrono C., Pugliese F., Ciabattoni G., Di Blasi S., Pierucci A., Cinotti G. A., Maseri A., Chierchia S. Prostacyclin does not affect insulin secretion in humans. Prostaglandins. 1981 Mar;21(3):379–385. doi: 10.1016/0090-6980(81)90083-6. [DOI] [PubMed] [Google Scholar]
  31. Peatfield R. C., Gawel M. J., Rose F. C. The effect of infused prostacyclin in migraine and cluster headache. Headache. 1981 Sep;21(5):190–195. doi: 10.1111/j.1526-4610.1981.hed2105190.x. [DOI] [PubMed] [Google Scholar]
  32. Rådegran K., Papaconstantinou C. Prostacyclin infusion during cardiopulmonary bypass in man. Thromb Res. 1980 Jul 1;19(1-2):267–270. doi: 10.1016/0049-3848(80)90426-0. [DOI] [PubMed] [Google Scholar]
  33. Szczeklik A., Gryglewski R. J., Nizankowski R., Musiał J., Pietoń R., Mruk J. Circulatory and anti-platelet effects of intravenous prostacyclin in healthy men. Pharmacol Res Commun. 1978 Jun;10(6):545–556. doi: 10.1016/s0031-6989(78)80053-8. [DOI] [PubMed] [Google Scholar]
  34. Szczeklik A., Gryglewski R. J., Nizankowski R., Skawiński S., Głuszko P., Korbut R. Prostacyclin therapy in peripheral arterial disease. Thromb Res. 1980 Jul 1;19(1-2):191–199. doi: 10.1016/0049-3848(80)90418-1. [DOI] [PubMed] [Google Scholar]
  35. Szczeklik A., Nizankowski R., Skawinski S., Szczeklik J., Gluszko P., Gryglewski R. J. Successful therapy of advanced arteriosclerosis obliterans with prostacyclin. Lancet. 1979 May 26;1(8126):1111–1114. doi: 10.1016/s0140-6736(79)91792-6. [DOI] [PubMed] [Google Scholar]
  36. Szczeklik A., Pietoń R., Sieradzki J., Nizankowski R. The effects of prostacyclin on glycemia and insulin release in man. Prostaglandins. 1980 Jun;19(6):959–968. doi: 10.1016/0090-6980(80)90128-8. [DOI] [PubMed] [Google Scholar]
  37. Szczeklik A., Szczeklik J., Nizankowski R., Głuszko P. Prostacyclin for acute coronary insufficiency. Artery. 1980;8(1):7–11. [PubMed] [Google Scholar]
  38. Szczeklik J., Szczeklik A., Nizankowski R. Prostacyclin for pulmonary hypertension. Lancet. 1980 Nov 15;2(8203):1076–1076. doi: 10.1016/s0140-6736(80)92291-6. [DOI] [PubMed] [Google Scholar]
  39. Turney J. H., Weston M. J. Dialysis without anticoagulants. Lancet. 1981 Sep 26;2(8248):693–693. doi: 10.1016/s0140-6736(81)91022-9. [DOI] [PubMed] [Google Scholar]
  40. Turney J. H., Williams L. C., Fewell M. R., Parsons V., Weston M. J. Platelet protection and heparin sparing with prostacyclin during regular dialysis therapy. Lancet. 1980 Aug 2;2(8188):219–222. doi: 10.1016/s0140-6736(80)90116-6. [DOI] [PubMed] [Google Scholar]
  41. Walker I. D., Davidson J. F., Faichney A., Wheatley D. J., Davidson K. G. A double blind study of prostacyclin in cardiopulmonary bypass surgery. Br J Haematol. 1981 Nov;49(3):415–423. doi: 10.1111/j.1365-2141.1981.tb07244.x. [DOI] [PubMed] [Google Scholar]
  42. Warrington S. J., Smith P. R., O'Grady J. Noninvasive assessment of the cardiovascular effects of prostacyclin (PGI2) in man. Eur J Cardiol. 1980;12(2):73–80. [PubMed] [Google Scholar]
  43. Wilhelmsson L., Wikland M., Wiqvist N. PGH2, TxA2 and PGI2 have potent and differentiated actions on human uterine contractility. Prostaglandins. 1981 Feb;21(2):277–286. doi: 10.1016/0090-6980(81)90145-3. [DOI] [PubMed] [Google Scholar]
  44. Zusman R. M., Crow J. W., Cato A. E., Tolkoff-Rubin N. Effects of prostacyclin infusion in uremic patients: hematologic and hemodynamic responses. Clin Pharmacol Ther. 1981 Aug;30(2):251–257. doi: 10.1038/clpt.1981.156. [DOI] [PubMed] [Google Scholar]
  45. Zusman R. M., Rubin R. H., Cato A. E., Cocchetto D. M., Crow J. W., Tolkoff-Rubin N. Hemodialysis using prostacyclin instead of heparin as the sole antithrombotic agent. N Engl J Med. 1981 Apr 16;304(16):934–939. doi: 10.1056/NEJM198104163041603. [DOI] [PubMed] [Google Scholar]
  46. Zygulska-Mach H., Kostka-Trabka E., Nitoń A., Gryglewski R. J. Prostacyclin in central retinal vein occlusion. Lancet. 1980 Nov 15;2(8203):1075–1075. doi: 10.1016/s0140-6736(80)92289-8. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES