Iloprost
Also known as: Ilomedin · Ventavis
Iloprost is an infusion I use when Raynaud's phenomenon becomes severe, or when fingertips develop ulcers that will not heal. It opens up the small blood vessels and improves blood flow to the fingers and toes.
Calm, careful medication review by a consultant rheumatologist.
For nurses and infusion staff
This is the two-page pack I use for iloprost infusions in day-care. Page one is the physician order sheet with the weight-based rate reference and titration steps. Page two is the infusion monitoring chart for vitals and side-effect checks. Nurses are welcome to print it for use in the infusion room.
What this medicine is
Iloprost is a prostacyclin analogue. It widens small blood vessels and reduces the tendency of platelets to clump, so more blood reaches the fingers and toes. It is given through a drip over several hours, usually on consecutive days.
Uses and context
I use it mainly in systemic sclerosis (scleroderma) and other connective tissue diseases, for severe Raynaud's attacks, painful digital ischaemia and digital ulcers that are not settling with tablets.
How this relates to rheumatology care
I start the infusion slowly and build the rate up in small steps every 30 minutes to the highest dose you tolerate comfortably. Headache, flushing and nausea are the usual limits, and we simply step back to the last comfortable rate. Most courses run over three to five days, and I review after the first three doses.
What safety checks may matter
Baseline weight, blood pressure, pulse and general observations
Vital signs repeated at every rate increase
Review of heart disease, low blood pressure and bleeding risk before starting
Careful check of the drip site, since iloprost can irritate the vein
Pregnancy and breastfeeding discussed before treatment
Side effects and red flags
If you have emergency symptoms such as severe allergic reaction, breathing difficulty, chest pain, stroke-like symptoms, severe abdominal pain, vomiting blood, black stools, sudden vision loss, severe infection symptoms, or severe weakness or confusion, please seek urgent medical care first rather than waiting for a WhatsApp reply.
Chest pain, severe breathlessness or fainting during the infusion
Severe headache, vomiting or dizziness that does not settle when the rate is reduced
Pain, swelling or redness at the drip site
New bleeding or unusual bruising
Signs of severe allergic reaction
Things worth knowing day to day
Eat before your infusion and stay well hydrated; this reduces headache and light-headedness.
Plan for a long day in the infusion room, up to eight hours per dose.
Do not drive yourself home after the first dose until you know how you react.
Tell the nurse straight away about headache or nausea; the rate can be adjusted.
Questions patients often ask me about this medicine
Speak with me
If your Raynaud's is severe or you have a digital ulcer that is not healing, please message my clinic. I would like to review whether an iloprost course would help.
Other medications used in rheumatology care
This page is for general education only and does not replace medical advice. Please consult a qualified healthcare professional for diagnosis and treatment. Do not start, stop, or change any medicine without advice from your doctor.