Flolan is not taken by mouth. It is given through a central venous catheter (a thin tube inserted into a large vein, usually in the chest or neck). A portable pump is used to give the medicine continuously.

Instructions for use:

• The IV pump must run 24/7, without stopping.
  
  
• The medicine must be mixed and prepared properly, often daily or every few days.
  
  
• Flolan must be kept cold until it is used.
  
  
• A trained nurse or caregiver will teach you how to prepare, store, and use the pump at home.
  
  

Important:

• Do not stop or disconnect the pump suddenly.
  
  
• If the infusion is stopped, serious health problems or death can occur.
  
  

Always keep an extra pump, supplies, and medicine in case of emergencies.

Flolan works by acting like a natural substance in the body called prostacyclin.

It:

• Widens (dilates) blood vessels in the lungs
  
  
• Lowers blood pressure in the lungs
  
  
• Prevents blood clots
  
  
• Helps the heart pump more easily
  
  

Because PAH causes tight or narrow arteries in the lungs, Flolan helps relax those arteries and improves blood flow. This reduces pressure and makes breathing easier.

Flolan, like all medicines, can cause side effects. Some are mild and go away with time. Others can be serious and need medical help.

Common Side Effects:

• Headache
  
  
• Nausea or vomiting
  
  
• Jaw pain
  
  
• Muscle or joint pain
  
  
• Flushing (warmth or redness of the skin)
  
  
• Diarrhea
  
  
• Low blood pressure (dizziness or light-headedness)
  
  

Serious Side Effects:

• Infection at the catheter site
  
  
• Sepsis (serious blood infection)
  
  
• Bleeding problems
  
  
• Heart rhythm changes
  
  
• Chest pain or fast heartbeat
  
  

If you experience fever, redness, or swelling near the catheter, or feel very weak or dizzy, get medical help immediately.

Before using Flolan, tell your doctor if you have:

• Bleeding problems
  
  
• Low blood pressure
  
  
• Liver or kidney disease
  
  
• Heart problems
  
  
• Recently had surgery
  
  
• Allergies to epoprostenol or any ingredients
  
  

Important Precautions:

• Do not stop the infusion suddenly.
  
  
• Avoid activities that may increase your risk of bleeding or injury.
  
  
• Be careful when changing the pump or catheter site to avoid infection.
  
  
• Keep supplies clean and use proper hygiene.
  
  
• Your doctor will monitor your blood pressure, heart function, and blood tests regularly.
  
  

Flolan is usually not used in pregnant women, unless the benefit is more than the risk. Talk to your doctor if you are pregnant or breastfeeding.

Flolan can interact with other medicines. These interactions may increase side effects or reduce how well it works.

Common Interactions include:

• Blood pressure medicines (e.g., diuretics, beta-blockers): Can cause very low blood pressure
  
  
• Blood thinners (e.g., warfarin, heparin): Increases the risk of bleeding
  
  
• NSAIDs (e.g., ibuprofen, aspirin): Can also increase bleeding risk
  
  
• Other vasodilators (medicines that widen blood vessels): May cause dizziness or fainting
  
  

Always tell your doctor about all the medicines you take, including herbal products and over-the-counter drugs.

General Guidelines:

• Starting dose: Usually 2 ng/kg/min (nanograms per kilogram per minute)
  
  
• Maintenance dose: Depends on the individual; adjusted slowly by the doctor
  
  

Your doctor will:

• Start at a low dose and increase slowly over several days
  
  
• Monitor how you feel and your side effects
  
  
• Adjust the dose to the highest amount you can handle without side effects
  
  

Because Flolan has a very short half-life, it must be given constantly. If the infusion stops, symptoms can return quickly and may be dangerous.

Always follow your care team’s instructions exactly.

Flolan is a specialized medicine, and it can only be given with a doctor’s prescription. It requires:

• A PAH diagnosis confirmed by tests
  
  
• Training on how to use the pump and catheter
  
  
• Home nursing support or special care providers
  
  
• Regular medical follow-up
  
  

Your doctor will:

• Check your heart and lung condition often
  
  
• Adjust your dose over time
  
  
• Monitor for side effects and complications
  
  

Flolan must be ordered through a specialty pharmacy and delivered with proper cooling equipment. You may also need to work with a home health service to manage your therapy.

• What is Flolan used for?
  Flolan is used to treat pulmonary arterial hypertension (PAH) — a condition where high blood pressure in the arteries of the lungs causes shortness of breath, fatigue, and heart strain.
  It helps improve exercise ability, oxygen delivery, and symptoms in adults with PAH, including primary (idiopathic) and associated forms (e.g., connective tissue disease).

• What is the brand name?
  Flolan® (manufactured by GlaxoSmithKline).

• What is the active ingredient?
  Epoprostenol sodium, a synthetic form of prostacyclin (PGI₂) — a natural substance that relaxes blood vessels and inhibits blood clotting.

• How does Flolan work?

  • Acts as a vasodilator, relaxing smooth muscles in pulmonary and systemic arteries.

  • Inhibits platelet aggregation, reducing risk of small clots in the lungs.

  • Improves cardiac output and oxygenation by lowering pulmonary vascular resistance.

• What type of medication is it?
  A prostacyclin analog / vasodilator / antiplatelet agent used for continuous infusion.

• How is Flolan administered?

  • By continuous intravenous (IV) infusion through a central venous catheter using a portable infusion pump.

  • Therapy is individualized and continuous — stopping suddenly can cause life-threatening rebound pulmonary hypertension.

  • Prepared from a lyophilized powder mixed with a sterile diluent just before use.

• What forms and strengths are available?

  • Vials of lyophilized powder: typically 0.5 mg or 1.5 mg of epoprostenol per vial.

  • Must be reconstituted and infused immediately or stored as directed (depending on formulation).

• How long does it take to work?

  • Hemodynamic effects occur within minutes of starting infusion.

  • Symptomatic improvements may take several days to weeks.

• What are the common side effects?

  • Flushing, headache, jaw pain

  • Nausea or vomiting

  • Diarrhea

  • Muscle or joint pain

  • Anxiety or restlessness

  • Mild hypotension (low blood pressure)

• Are there serious side effects?
  Yes, possible severe reactions include:

  • Severe hypotension or fainting

  • Bleeding due to platelet inhibition

  • Catheter-related infections or sepsis

  • Rebound pulmonary hypertension if the infusion is interrupted

  • Tachycardia or chest pain

• Who should not receive Flolan?

  • People with heart failure from left ventricular dysfunction

  • Those with hypersensitivity to epoprostenol or formulation components

  • Patients for whom continuous infusion therapy is not possible or safe

• Can it be used in children?
  Yes — sometimes used in pediatric PAH under specialist supervision, with weight-based dosing.

• Can it be used during pregnancy?
  Use only if clearly needed. Limited data exist, but it may be used if benefits outweigh risks for the mother and fetus in severe PAH.

• Can it be used while breastfeeding?
  Unknown if excreted in breast milk; use with caution under medical advice.

• Does Flolan interact with other medications?
  Yes — major interactions include:

  • Antihypertensive drugs — may cause additive low blood pressure

  • Anticoagulants or antiplatelet agents (e.g., warfarin, aspirin) — increased bleeding risk

  • Vasodilators or nitrates — may enhance hypotensive effects

• How should Flolan be stored and prepared?

  • Store unopened vials at 2–8°C (36–46°F).

  • Once reconstituted, keep solution cold and protected from light.

  • Stability depends on formulation — some newer versions (e.g., Flolan with pH-stable diluent) allow room-temperature storage for up to 24 hours.

  • Must be infused continuously; never stop abruptly.

• Is there a generic available?
  Yes — Epoprostenol is available generically, as well as in alternative brands such as Veletri® (room-temperature-stable formulation).

• Where can I get it?

  • Prescription only, administered under supervision of a specialized PAH treatment center or home-infusion program.