Prostin VR Dosage/Direction for Use

The infusion is generally initiated at a rate of 0.05 to 0.1 micrograms alprostadil per kilogram of body weight per minute. Starting dosages lower than that have been used with apparent good response, but this experience has been largely anecdotal. The most experience has been with 0.1 microgram/kg/min.
After a therapeutic response is achieved (increased pO₂ in infants with restricted pulmonary blood flow or increased systemic blood pressure and blood pH in infants with restricted systemic blood flow), reduce the infusion rate to provide the lowest possible dosage that maintains the response.
If response to 0.1 microgram/kg/min is inadequate, dosage can be cautiously increased up to 0.4 microgram/kg/min although, in general, higher infusion rates do not produce greater effects.
The preferable route of administration for PROSTIN VR solution for infusion is by continuous intravenous infusion into a large vein. Alternatively, PROSTIN VR may be administered through an umbilical artery catheter with its tip positioned at the ductal opening. Increases in blood oxygenation (pO₂) are similar by both routes of administration.
DILUTION INSTRUCTIONS: To prepare infusion solution, dilute 0.2 ml, 0.5 ml or 1 ml of PROSTIN VR Concentrate for solution for infusion with sterile sodium chloride solution or sterile dextrose (or glucose) solution. If undiluted PROSTIN VR Concentrate for solution for infusion comes in direct contact with a plastic container, plasticizers are leached from the sidewalls. The solution may turn hazy and the appearance of the container may change. Should be discarded and the plastic container should be replaced. This appears to be a concentration-dependent phenomenon. To minimize the possibility of haze formation, PROSTIN VR Concentrate for solution for infusion should be added directly to the intravenous infusion solution avoiding contact with the walls of plastic containers. Dilute to volumes appropriate for the pump delivery system available. Prepare fresh dilution every 24 hours. Discard any dilution more than 24 hours old. (See table.)

Click on icon to see table/diagram/image

Calculations: See Equation 1.

Click on icon to see table/diagram/image

EXAMPLE: To provide 0.1 μg/kg/min to a 2.8 kg neonate, using a final alprostadil concentration of 5 μg/ml: See Equation 2.

Click on icon to see table/diagram/image

IMPORTANT: No ampoule file is needed to open the ampoule is prescored at the point of constriction. A colored dot on the ampoule head helps to orientate the ampoule. Take the ampoule and face the colored dot. The ampoule opens easily by placing the thumb on the colored dot and gently pressing downwards.
WAYS OF ADMINISTRATION: Intra-arterial or intravenous administration.