Advanced thromboangiitis obliterans (Buerger's disease) w/ critical limb ischemia in cases where revascularization is not indicated. Severe peripheral arterial occlusive disease (PAOD), particularly those patients at risk of amputation & in whom surgery or angioplasty is not possible. Severe disabling Raynaud's phenomenon unresponsive to other therapies.
Adjust dose according to individual tolerability w/in 0.5-2 ng/kg/min over 6 hr daily by IV infusion for up to 4 wk. First 2-3 days: 0.5 ng/kg/min over 30 min. Duration of treatment for Raynaud's phenomenon: 3-5 days.
Hypersensitivity. Conditions which might increase risk of hemorrhage eg, active peptic ulcer, trauma, intracranial hemorrhage. Severe CHD or unstable angina; MI w/in previous 6 mth; acute or chronic CHF (NYHA II-IV); severe arrhythmias; suspected pulmonary congestion. Pregnancy & lactation.
Surgery should not be delayed in patients requiring urgent amputation (eg, infected gangrene). Smoking cessation is recommended. Use cautiously in patients w/ low BP; significant heart disease; CVA (eg, transient ischemic attack, stroke) w/in the last 3 mth. Risk of orthostatic hypotension. Oral ingestion & mucous membrane contact must be avoided; long-lasting but painless erythema upon skin contact. Hepatic dysfunction & renal failure requiring dialysis. Adolescents & childn.
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