How does this medication work? What will it do for me?

Alprostadil, also known as prostaglandin E1, belongs to a class of medications known as vasodilators. It is used to treat babies with certain types of congenital heart defects. It keeps the ductus arteriosus (a passageway in the heart) open until surgery can be done.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why your baby is being given this medication, speak to your doctor.

What form(s) does this medication come in?

Each 1 mL ampule contains alprostadil 500 µg in anhydrous ethanol.

How should I use this medication?

The recommended initial dosage of alprostadil is calculated by your doctor based on body weight. When the desired effect on the ductus arteriosus (a passageway in your baby's heart) is achieved, the infusion rate is usually decreased to the lowest possible dose while still maintaining the desired effect on the ductus arteriosus.

Alprostadil is usually given through a continuous intravenous infusion into a vein by a health care professional in a hospital setting. It can also be given into an artery at the opening of the ductus arteriosus.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. Your doctor may have recommended a different dose from the one listed here.

Store this medication in the refrigerator at 2°C to 8°C. Once the medication has been prepared by dilution, it must be used within 24 hours, after which it must be discarded. Protect from light and keep out of reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Alprostadil should not be used by anyone who:

  • is allergic to alprostadil or to any of the ingredients of the medication
  • has certain heart or lung conditions which, in their doctor's judgment, would make it dangerous for them to use this medication

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your baby's doctor.

While your baby is receiving alprostadil, health care professionals in the hospital will be monitoring your baby for any possible side effects. The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if your baby experiences these side effects and they are severe or bothersome.

  • apnea (episodes of regular breathing with pauses)
  • diarrhea
  • fever
  • flushing
  • infections
  • low blood pressure (symptoms include dizziness or fainting)
  • slow or fast heartbeat
  • swelling of the feet or legs

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your baby's doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal heart rhythm
  • blood in urine or decreased urination
  • bluish skin colour
  • convulsions or seizures
  • feeling drowsy or sluggish
  • hypothermia (abnormally low body temperature)
  • irritability or jitteriness
  • low blood sugar levels (e.g., dizziness, lack of energy, sweating, or shakiness)
  • low potassium levels (e.g., weakness, muscle cramps, constipation, nausea or vomiting, heart palpitations, increased thirst or urination, tingling or numbness)
  • stiffness

Stop the medication and seek immediate medical attention if any of the following occur:

  • bleeding
  • cardiac arrest
  • signs of a serious allergic reaction (e.g., shortness of breath or difficulty breathing; hives; swelling of the eyes, mouth, lips, or throat)
  • troubled breathing or stopped breathing

Some people may experience side effects other than those listed. Check with your baby's doctor if you notice any symptom that worries you while your baby is on this medication.

Are there any other precautions or warnings for this medication?

Before your baby begins using a medication, be sure to inform your doctor of any medical conditions or allergies your baby may have, any medications your baby is taking, and any other significant facts about your health. These factors may affect how your baby will receive this medication.

Bleeding disorders: If your baby has a bleeding disorder, discuss this with your baby's doctor to see how this medication may affect your baby's medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hospital use: This medication should only be given by a trained health care professional in a hospital setting.

Lung problems: If your baby has any lung problems, discuss this with your baby's doctor to see how this medication may affect your baby's medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Other heart problems: If your baby has other heart problems or low blood pressure, discuss this with your baby's doctor to see how this medication may affect your baby's medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

What other drugs could interact with this medication?

If your baby is taking any other medications or supplements, speak with your doctor or pharmacist. Depending on the specific circumstances, the doctor may recommend:

  • stopping one of the medications,
  • changing one of the medications to another,
  • changing how one or both of the medications are being taken, or
  • leaving everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.