Details
Alprostan Indications
- Chronic lower limb ischemia stage in pain at rest and trophic changes (stages III and IV).
- Critical congenital heart defects in newborns associated with cleft arterial duct in which indicated surgical reconstruction (in order of temporary functioning arterial duct before the corrective surgery).
Contraindications
Chronic lower limb ischemia:
- Hypersensitivity to the active substance or to any of the excipients;
- Pregnancy and / or lactation;
- Ischemic heart disease, acute or subacute myocardial infarction, myocardial infarction within the past 6 months, insufficiency or stenosis of the aortic or E tral valves, uncontrolled coronary heart disease, acute or subacute heart attack, unstable angina or severe stable angina, decompensated heart failure, serious heart rhythm disorder;
- Chronic obstructive bronchopulmonary disease at the stage respiratory failure, venooklyuzyvni lung disease, pulmonary edema or presence of pulmonary infiltrate, confirmed by X-ray examination or clinically;
- Acute liver failure or severe chronic liver disease;
- Existing risk of bleeding complications (stroke, gastric ulcer or duodenal ulcer, proliferative retinopathy with a tendency to bleeding / hemorrhage, polytrauma, etc.).
Newborn:
- Hypersensitivity to the active substance or to any of the excipients;
- Respiratory distress syndrome;
- Spontaneously sustained cleft arterial duct.
Dosage & Administration
Adults
In adults for the treatment of chronic lower limb ischemia drug is used intravenously for several weeks. The recommended dose is 50 to 200 mg / day, administered once a day or as two separate doses for at least a two-hour infusion of 200 - 500 ml of the drug.
As the solvent used isotonic solution of sodium chloride (saline), 5% or 10% glucose. This solution should be prepared immediately before infusion into the patient.
The course of treatment should last at least two weeks; in the case of a positive effect of treatment should be carried out for another 7 - 14 days. However, treatment should not exceed four weeks. If the first two weeks of treatment is not achieved the desired effect, the drug should be discontinued.
Newborns
Alprostadil is desirable to use via continuous intravenous infusion (as an alternative to entering the arterial duct through the umbilical artery). The recommended starting dose is 0.01 - 0.05 mg / kg / min; in the case of registration of therapeutic response, ie signs of opening or reopening of the arterial duct, the dose should be reduced to the minimum effective therapeutic dose (typically 0.01 - 0.02 mg / kg / min). In exceptional cases, if the initial dose is not effective, the dose can be increased to 0.1 mcg / kg / min. Serious adverse reactions to the drug - a reason for dose reduction.
