Parenteral and inhaled prostanoid therapy in the treatment of pulmonary arterial hypertension

Clin Chest Med. 2013 Dec;34(4):825-40. doi: 10.1016/j.ccm.2013.09.003. Epub 2013 Oct 18.


Since continuous IV epoprostenol was approved in the U.S., parenteral prostanoid therapy has remained the gold standard for the treatment of patients with advanced pulmonary arterial hypertension (PAH). Prostanoid agents can be administered as continuous intravenous infusions, as continuous subcutaneous infusions and by intermittent nebulization therapy. This article presents data from clinical trials of available prostanoid agents, and their varied routes of administration. The varied routes of administration allow for the incremental use of this class of agents in advanced PAH, and if PAH progresses. Prostanoids will remain a major component of PAH therapy for the foreseeable future.

Keywords: Epoprostenol; Iloprost; Inhaled therapy; Intravenous therapy; Parenteral therapy; Prostacyclins; Prostanoids; Treprostinil.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / pharmacokinetics
  • Epoprostenol / administration & dosage*
  • Epoprostenol / adverse effects
  • Epoprostenol / analogs & derivatives
  • Epoprostenol / pharmacokinetics
  • Familial Primary Pulmonary Hypertension
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Iloprost / administration & dosage*
  • Iloprost / adverse effects
  • Infusions, Intravenous


  • Antihypertensive Agents
  • Epoprostenol
  • Iloprost
  • treprostinil