• Generic Name: iloprost
  • Brand Name: Ventavis
  • Drug Class: PAH, Prostacyclin Analogs
Last updated on MDtodate: 10/8/2022


Clinical Studies Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Pre-marketing safety data on Ventavis were obtained from 215 patients with pulmonary arterial hypertension receiving iloprost in two 12-week clinical trials and two long-term extensions. Patients received inhaled Ventavis for periods of from 1 day to more than 3 years. The median number of weeks of exposure was 15. Forty patients completed 12 months of open-label treatment with iloprost.

The following table shows adverse events reported by at least 4 Ventavis patients and reported at least 3% more frequently for Ventavis patients than placebo patients in the 12-week placebo-controlled study.

Table 1: Adverse Events in Phase 3 Clinical Trial

Adverse Event Ventavis
n = 101
n = 102
Placebo subtracted
Vasodilation (flushing) 27 9 18
Cough increased 39 26 13
Headache 30 20 10
Trismus 12 3 9
Insomnia 8 2 6
Nausea 13 8 5
Hypotension 11 6 5
Vomiting 7 2 5
Alk phos increased 6 1 5
Flu syndrome 14 10 4
Back pain 7 3 4
Tongue pain 4 0 4
Palpitations 7 4 3
Syncope 8 5 3
GGT increased 6 3 3
Muscle cramps 6 3 3
Hemoptysis 5 2 3
Pneumonia 4 1 3


Pre-marketing serious adverse events reported with the use of inhaled Ventavis and not shown in Table 1 include congestive heart failure, chest pain, supraventricular tachycardia, dyspnea, peripheral edema, and kidney failure.

In a small clinical trial (the STEP trial), safety trends in patients receiving concomitant bosentan and Ventavis were consistent with those observed in the larger experience of the Phase 3 study in patients receiving only Ventavis or bosentan.

Adverse Events With Higher Doses

In a study in healthy subjects (n=160), inhaled doses of iloprost solution were given every 2 hours, beginning with 5 mcg and increasing up to 20 mcg for a total of 6 dose inhalations (total cumulative dose of 70 mcg) or up to the highest dose tolerated in a subgroup of 40 subjects. There were 13 subjects (32%) who failed to reach the highest scheduled dose (20 mcg). Five were unable to increase the dose because of (mild to moderate) transient chest pain/discomfort/tightness, usually accompanied by headache, nausea, and dizziness. The remaining 8 subjects discontinued for other reasons.

Postmarketing Experience

The following adverse reactions have been identified during the postapproval use of Ventavis. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Cases of bronchospasm and wheezing have been reported, particularly in patients with a history of hyperreactive airways. Bleeding events most commonly reported as epistaxis and hemoptysis were observed on Ventavis treatment . Cases of thrombocytopenia, dizziness, diarrhea, mouth and tongue irritation, nasal congestion, dysgeusia, hypersensitivity, and rash have also been reported with the use of Ventavis.