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Veletri 1.5mg Injection
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Indications & Clinical Uses
- Veletri 1.5 mg contains epoprostenol, a prostacyclin, supplied as a lyophilized powder for injection in 0.5 mg and 1.5 mg vials.
- In the US it is approved for the treatment of pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity, particularly in patients with NYHA Functional Class III-IV symptoms.
- It is given as a continuous intravenous infusion through a central venous catheter using an ambulatory infusion pump.
- Veletri is marketed by Actelion Pharmaceuticals US, a Janssen company.
- It is not the same preparation as Flolan, the earlier epoprostenol product: Veletri uses different reconstitution diluents and has different stability, so the preparation and storage steps differ.
Side Effects
- During dose initiation, common side effects are flushing (58%), headache (49%), nausea and vomiting (32%) and low blood pressure (16%).
- During long-term dosing, common effects are headache, jaw pain, flushing, diarrhoea, nausea and vomiting, flu-like symptoms, and anxiety or nervousness.
- The most important serious risk is rebound pulmonary hypertension after abrupt withdrawal, including interruptions in drug delivery, or sudden large reductions in dose.
- The current US label for Veletri carries no boxed warning.
- Contact your PAH care team immediately if the infusion is interrupted or you have worsening breathlessness, dizziness or fainting.
Precautions & Warnings
- Veletri is contraindicated in patients with congestive heart failure due to severe left ventricular systolic dysfunction, in patients with pulmonary oedema, and in those with hypersensitivity to epoprostenol or structurally related compounds.
- Never stop or interrupt Veletri abruptly or reduce the dose suddenly.
- The powder is reconstituted only with Sterile Water for Injection or 0.9% Sodium Chloride Injection, and must not be mixed with other medicines or solutions.
- Check whether you have Veletri or another epoprostenol product, as the diluent and stability differ; Veletri comes in 0.5 mg and 1.5 mg vials, so confirm the vial strength.
- Limited data do not establish a drug-associated risk in pregnancy, but untreated PAH poses risks to mother and baby, so discuss this with your specialist.
- Store unopened vials at 20°C to 25°C in the original carton, protected from direct sunlight.
Avoid Interactions
- Drugs that increase effect or toxicity: diuretics and antihypertensive agents can add to the blood-pressure-lowering effect; antiplatelet agents and anticoagulants may increase the risk of bleeding; digoxin concentrations may rise, and patients susceptible to toxicity should be watched.
- Drugs that reduce efficacy: no specific drugs are named in the label sections reviewed.
- Tell your specialist about all prescription and over-the-counter medicines, vitamins and herbal supplements.
- Pharmacy point: reconstitute only with the approved diluents, and do not mix Veletri with other medicines or solutions in the same infusion line.
- Ask your specialist before starting any new medicine, including over-the-counter products.
References
Frequently Asked Questions
Veletri (epoprostenol) is used to treat pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity, especially in people with NYHA Class III-IV symptoms. It is a continuous intravenous infusion. Veletri contains epoprostenol as a powder that is reconstituted before use. It is not the same product as Flolan, so follow the instructions for Veletri.
Veletri (epoprostenol) is given as a continuous infusion into a vein through a central venous catheter, using an ambulatory infusion pump. The powder is reconstituted only with Sterile Water for Injection or 0.9% sodium chloride and is not mixed with other medicines. Follow your care team's preparation instructions.
Common Veletri side effects include flushing, headache, nausea, vomiting, jaw pain, diarrhoea, low blood pressure, flu-like symptoms and anxiety. The main serious risk is rebound pulmonary hypertension if the infusion stops suddenly. The US label has no boxed warning. Contact your PAH team at once for worsening breathlessness or fainting.
Avoid stopping Veletri (epoprostenol) suddenly or letting the infusion run out. Do not mix it with other medicines or solutions. Tell your specialist if you take diuretics, blood pressure medicines, blood thinners, antiplatelets or digoxin, because Veletri can add to their effects. It is contraindicated in severe left heart failure.
Do not let a Veletri (epoprostenol) infusion stop. Abrupt withdrawal, including pump or catheter interruptions, may cause rebound pulmonary hypertension with worsening breathlessness or fainting. Contact your PAH care team immediately if delivery stops. Do not stop or reduce the dose yourself; sudden large dose reductions can also cause rebound symptoms.
Veletri (epoprostenol) uses different reconstitution diluents and has different stability from the older epoprostenol product Flolan, so preparation and storage steps differ. Follow the instructions for the exact brand you have. Unopened Veletri vials are stored at 20°C to 25°C in the carton, protected from direct sunlight.
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