PROSTIN VR PEDIATRIC Rx
Generic Name and Formulations:
Alprostadil 500mcg/mL; soln for IV infusion after dilution; contains dehydrated alcohol.
Indications for PROSTIN VR PEDIATRIC:
Palliative therapy to maintain ductus arteriosus patency until corrective or palliative surgery can be performed in neonates with congenital heart defects and who depend on patent ductus for survival.
Use lowest effective dose for shortest duration. Give by continuous IV infusion into large vein (preferred) or through an umbilical artery catheter placed at the ductal opening. Initially 0.05–0.1mcg/kg/min. Reduce dose from 0.1 to 0.05 to 0.025 to 0.01mcg/kg/min after therapeutic response is achieved to provide lowest dose that maintains response. If inadequate response to 0.05mcg/kg/min; may increase up to 0.4mcg/kg/min.
Respiratory distress syndrome: not recommended. Bleeding disorders. Prolonged therapy (>120hrs): monitor for antral hyperplasia and gastric outlet obstruction. Monitor respiratory status, arterial pressure, blood oxygenation, BP, blood pH; decrease infusion rate if arterial pressure falls significantly. Neonates <2kg at birth.
Caution with anticoagulants.
Apnea, fever, flushing, bradycardia, hypotension, tachycardia, seizures, diarrhea, sepsis, cortical proliferation of the long bones (long-term infusion).