Iloprost is a synthetic prostacyclin analogue used in the treatment of critical limb ischaemia in patients at risk of amputation where surgical revascularisation or angioplasty is not indicated or has failed, or for severe Raynaud’s phenomenon. It improves circulation by dilating systemic vascular beds, inhibiting platelet aggregation and exerting an anti-inflammatory effect on injured tissue. For both indications it is usually given as an infusion for 6 hours a day for five days. The decision to prescribe iloprost should be led by a consultant rheumatologist or vascular surgeon.
It is worth noting that unlike other medicines where the dose is fixed and given over a set period of time, the licensing for iloprost means that the duration of infusion is fixed, 6 hours, but the total dose will vary between patients depending on characteristics such as weight and tolerance. In some circumstances treatment may be extended beyond 6 hours in 24 hours at the discretion of the prescribing consultant. This is however on off label use and should be considered on a case by case basis.