Epoprostenol (Flolan) — Mechanism & Rationale

Epoprostenol is a specialized IV medication used to treat severe pulmonary arterial hypertension. This page explains what it does and why it's infused continuously — it is not a dosing calculator.

Why Continuous Infusion

Epoprostenol's half-life is only a few minutes, so a steady effect requires a nonstop intravenous infusion through a central line and pump. Because abruptly stopping it can trigger dangerous rebound pulmonary hypertension, patients carry backup medication and pump supplies at all times.

Where It Fits

It is reserved for severe (often WHO functional class III–IV) pulmonary arterial hypertension, managed by specialists. Related infused and inhaled prostacyclin analogues exist with longer half-lives, but continuous IV epoprostenol remains a benchmark therapy for the sickest patients.

A Prostacyclin Vasodilator

Epoprostenol relaxes the pulmonary arteries and reduces clotting, lowering pulmonary pressure.

pulmonary artery dilates vasodilation + less clotting

Frequently Asked Questions

Why does epoprostenol need continuous IV infusion instead of a pill?

It has an extremely short half-life (a few minutes) and breaks down rapidly in the body, so continuous delivery is required to maintain a stable effect. Even brief interruptions can cause rebound pulmonary hypertension.

What does epoprostenol do?

It's a prostacyclin analogue that dilates the pulmonary arteries and inhibits platelet aggregation, lowering pulmonary vascular resistance in severe pulmonary arterial hypertension.

Is this a dosing calculator?

No. Given RespCalc's non-clinician audience, this page stays mechanism- and rationale-focused. It is not a bedside dosing or titration tool.

How is it delivered safely?

Through a permanent central venous catheter and a portable infusion pump, with careful backup planning because of the danger of any interruption.

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