Pulmonary Hypertension Program

pulmonary hypertension program

Medications


Flolan® (epoprostenol)Flolan

Flolan® acts like a molecule in the body called prostacyclin, which causes the arteries from the heart to the lungs to widen. This causes a decrease in blood pressure.

Important Points:

  • Flolan® has a short lifespan, so it must be given as a continuous infusion into the vein using a special pump

  • Flolan® must be mixed with a special liquid before putting it into the pump. It is not good for more than 48 hours
  • It can be life-threatening if Flolan® is stopped suddenly. DO NOT stop without talking to your doctor first.
  • Flolan® must be protected from light
  • Flolan® must be kept on ice
  • Your cartridge of Flolan® must be changed every day
  • Flolan® is started at a small dose and then slowly increased until the blood pressure in the pulmonary arteries is at goal
  • Use Flolan® just as your doctor prescribes; do not change your dose without checking with your doctor

Common Side Effects of Flolan®:

  • HeadacheFlolan in vein
  • Jaw pain
  • Nausea
  • Anxiety
  • Flushing
  • Dizziness

Call your doctor immediately if you feel:

  • Chest pain
  • Fainting
  • Fever or chills
  • Very slow or fast heartbeat
  • Trouble breathing


Remodulin® (treprostinil)Remodulin

Purpose: Remodulin® acts like a molecule in the body called prostacyclin, which causes the arteries from the heart to the lungs to widen. This causes a decrease in blood pressure.

Remodulin® acts like a molecule in the body called prostacyclin, which causes the arteries from the heart to the lungs to widen. This causes a decrease in blood pressure.

Important Points:

  • Remodulin® has a short lifespan, so it must be given as a continuous infusion under the skin or through a vein using a special pump
  • Remodulin® should never be stopped suddenly because that may cause a rapid increase in blood pressure that can be very dangerous
  • Remodulin® should be stored at room temperature and protected from light for up to 72 hours
  • Remodulin® is started at a small dose and then slowly increased until the blood pressure in the pulmonary arteries is at goal
  • Use Remodulin® just as your doctor prescribes; do not change your dose without checking with your doctor

Common Side Effects of Remodulin®:

  • Injection site pain
  • Headache
  • Jaw pain
  • Nausea
  • Diarrhea
  • Anxiety
  • Flushing

Call your doctor immediately if you feel:

  • Fainting
  • Fever or chills
  • Trouble breathing
  • Severe nausea, vomiting, or diarrhea


Lasix® (furosemide)Lasix

Purpose: Lasix® is a diuretic, also known as a water pill, that helps rid the body of extra fluid. This fluid may build up in the lungs and make it hard to breathe. This medication works by making the body urinate more often.

Lasix® is a diuretic, also known as a water pill, that helps rid the body of extra fluid. This fluid may build up in the lungs and make it hard to breathe. This medication works by making the body urinate more often.

Important Points:

  • Since Lasix® causes you to urinate, it should be taken in the morning unless your health care professional tells you differently
  • Lasix® may cause the body to lose potassium and magnesium, so your blood should be tested to make sure these levels are normal. If the levels are too low, your health care provider may tell you to take potassium or magnesium pills.

Common Side Effects of Lasix®:

  • You may experience dizziness or lightheadedness when standing up. If this problem worsens, call your health care provider.
  • Symptoms you may experience if your potassium or magnesium levels are too low include dry mouth, increased thirst, skipped heartbeats, muscle cramps, or weakness. Contact your health care provider if you have any of these symptoms.
  • If you experience a rash, call your health care provider immediately.
     

Coumadin® (warfarin)

Purpose: Coumadin®, also known as a blood thinner, decreases the ability of blood to clot. When taking Coumadin® your blood will take longer to clot, causing you to bleed for longer. Patients with pulmonary hypertension have an increased risk of developing blood clots which can become stuck in the lungs. Coumadin® helps to prevent these clots from forming.

Coumadin®, also known as a blood thinner, decreases the ability of blood to clot. When taking Coumadin® your blood will take longer to clot, causing you to bleed for longer. Patients with pulmonary hypertension have an increased risk of developing blood clots which can become stuck in the lungs. Coumadin® helps to prevent these clots from forming.

Important Points:

  • Since Coumadin® will make your bleeding time longer, it is important to check your urine and stool for blood to make sure you are not bleeding internally. If you notice blood in your urine or stool, contact your health care provider immediately.
  • Coumadin® requires careful monitoring by a health care provider using a test called INR. This measures how long it takes your blood to clot by sampling a small drop of blood.
  • Coumadin® can interact with many other medications, so tell your health care provider about any prescription, over the counter, and herbal medications you are taking.
  • Coumadin® acts by inhibiting the vitamin K dependent clotting factors, so it is important to keep the amount of vitamin K in your diet consistent. Foods that are high in vitamin K include green leafy vegetables such as broccoli, spinach, and collard greens.

Common Side Effects of Coumadin®:

  • Headache
  • Upset stomach
  • Diarrhea
  • Skin rash
  • Fever
      

Digoxin

Purpose: Digoxin makes the heart beat stronger and more regularly. Some patients with pulmonary hypertension develop a weak heart due to the high blood pressure in the arteries from the heart to the lungs. Digoxin helps the heart pump blood more effectively.

Digoxin makes the heart beat stronger and more regularly. Some patients with pulmonary hypertension develop a weak heart due to the high blood pressure in the arteries from the heart to the lungs. Digoxin helps the heart pump blood more effectively.

Common Side Effects of Digoxin:

  • Loss of appetiteDigoxin
  • Nausea or vomiting
  • Feeling tired or weak
  • Feeling confused
  • An irregular heartbeat

Call your doctor immediately if you:

  • Feel dizzy
  • Have blurry vision
  • If the way you see color changes
      

Revatio® (sildenafil)

RevatioPurpose: Revatio® acts by inhibiting the breakdown of cGMP, a molecule that causes the arteries from the heart to the lungs to widen. Revatio® allows cGMP to stay in the arteries longer which allows blood to flow through more easily. It also decreases blood pressure in these arteries.

Revatio® acts by inhibiting the breakdown of cGMP, a molecule that causes the arteries from the heart to the lungs to widen. Revatio® allows cGMP to stay in the arteries longer which allows blood to flow through more easily. It also decreases blood pressure in these arteries.

Important Points:

  • You should not take Revatio® if you take nitrate medications such as nitroglycerin or Imdur®
  • You should not take Revatio® after eating a high fat meal

Common Side Effects of Revatio®:

  • Nosebleeds
  • Headache
  • Flushing
  • Indigestion
      

Tracleer® (bosentan)

Purpose: Tracleer® works against endothelin, a molecule that causes the arteries to narrow. Tracleer® causes widening of the arteries from the heart to the lungs which decreases the blood pressure in these arteries.

Tracleer® works against endothelin, a molecule that causes the arteries to narrow. Tracleer® causes widening of the arteries from the heart to the lungs which decreases the blood pressure in these arteries.

Important Points:Tracleer

  • Tracleer® should never be taken if you are pregnant because it can cause very serious birth defects. Two forms of contraception are required while you are taking Tracleer®.
  • Tracleer® must be purchased from special pharmacies. It is not sold by your local pharmacy.
  • The dose of Tracleer® is started low and gradually increased every month until the blood pressure in the pulmonary arteries is at goal.
  • Tracleer® may interact with other medications. Be sure to tell your health care provider about any prescription, over the counter, or herbal medications that you take.
  • Do not stop taking Tracleer® suddenly without asking your health care provider.
  • You will have your blood checked monthly to monitor your liver. Your doctor may also
    monitor your red blood cell count. It is important not to miss these appointments.

Side Effects of Tracleer®:

  • Low red blood cell count. You should have your blood checked at regular visits to monitor for this side effect.
  • Liver dysfunction. You should have your blood checked at regular visits. Signs of liver dysfunction include dark colored urine, pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellowish skin
  • Headache
  • Irregular heartbeat
  • Rapid weight gain

Ventavis® (iloprost)Ventavis

Purpose: Ventavis® acts like prostacyclin, a molecule in the body that causes widening of the arteries from the heart to the lungs. By taking Ventavis®, the pulmonary arteries are widened which decreases the blood pressure.

Ventavis® acts like prostacyclin, a molecule in the body that causes widening of the arteries from the heart to the lungs. By taking Ventavis®, the pulmonary arteries are widened which decreases the blood pressure.

Important Points:

  • Ventavis® is given by inhalation through a machine called a nebulizer.
  • Because Ventavis® does not last very long in the body, it must be taken several times per day.
  • You must use the same nebulizer machine at all times, even if you go to the hospital.
  • Ventavis® is started at a low dose and slowly increased until the blood pressure in the pulmonary arteries is at goal.

Common Side Effects of Ventavis®:

  • Fainting
  • Flushing
  • Cough
  • Headache
 
 
 

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