title: Pharmacokinetic evaluation of continuous intravenous epoprostenol.
abstract: BACKGROUND
  prostacyclin is the main arachidonic acid metabolite and its decrease has been proven to be important in the pathophysiology of the pulmonary arterial hypertension (PAH). Epoprostenol has been the first analog of prostacyclin to be approved for the treatment of PAH and despite the development of therapeutic options, the last recommendations of European Societies of Cardiology and Pulmonology maintain it as the first choice therapy for severe patients in the WHO functional class IV. In this review, we focus on pharmacokinetics of epoprostenol characterized by its instability in aqueous biological fluids and compare its pharmacokinetics with other stable analogs of prostacyclin. Moreover, pharmacodynamics, clinical efficacy and safety of epoprostenol were studied.
  
  
  METHODS
  a literature search and review of the studies published on epoprostenol were carried out using the MEDLINE database.
  
  
  RESULTS
  the paper provides the reader with information on epoprostenol pharmacokinetics and comparison with other analogs of prostacyclin. This paper also provides data on pharmacodynamics, clinical efficacy, safety and tolerability of epoprostenol.
  
  
  CONCLUSIONS
  despite epoprostenol's short half-life and complicated delivery system, this treatment remains the first choice therapy for severe PAH patients.
authors.affiliation: Univ Paris-Sud, Faculté de Médecine, Kremlin-Bicêtre, F-94276, France.
authors.forename: Marie-Camille
authors.initials: MC
authors.lastname: Chaumais
authors.forename: Marion
authors.initials: M
authors.lastname: Jobard
authors.forename: Alice
authors.initials: A
authors.lastname: Huertas
authors.forename: Claire
authors.initials: C
authors.lastname: Vignand-Courtin
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.forename: Olivier
authors.initials: O
authors.lastname: Sitbon
authors.forename: André
authors.initials: A
authors.lastname: Rieutord
authors.forename: David
authors.initials: D
authors.lastname: Montani
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D011464:Epoprostenol / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D006207:Half-Life; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology; D007262:Infusions, Intravenous; D012720:Severity of Illness Index
chemical_list: D000959:Antihypertensive Agents; D011464:Epoprostenol