Type of Drug:

Antiplatelet agent; pulmonary artery vasodilator.

How the Drug Works:

Pulmonary artery hypertension is excessive blood pressure in the pulmonary arteries (arteries in the lung). Treprostinil dilates (widens) pulmonary arteries and reduces elevated blood pressure in the pulmonary arteries. It also keeps platelets (blood cells that aid in blood clot formation) from clumping together.

Uses:

For the treatment of pulmonary arterial hypertension (PAH) in patients with New York Heart Association (NYHA) Class II through IV symptoms to reduce symptoms (eg, difficulty breathing, chest pain, fatigue) associated with exercise.

Precautions:

Do not use in the following situations: Allergy to the drug or any of its ingredients.

Use with caution in the following situations: kidney disease liver disease

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible risks to the fetus.

Breastfeeding: It is not known if treprostinil appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children younger than 16 years of age have not been established.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-­the-counter or prescription medications or dietary supplements with this drug. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with this drug:

• Anticoagulants (eg, warfarin)
• Blood pressure-reducing agents (eg, diuretics, antihypertensivo agents, vasodilators)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include: Circulatory System: Low blood pressure; widening of the blood vessels (vasodilation) .

Other: Infusion site reaction (eg, redness, hardness, rash); infusion site pain, bleeding, or bruising; headache; rash; jaw pain; itching; dizziness; diarrhea; nausea.

Guidelines for Use:

• This medicine will usually be prepared and administered by your health care provider in a medical setting, but may be administered at home if your doctor feels it is safe to do so.
• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• If medicine needs to be stopped, the dose will usually be slowly reduced before being stopped completely.
• Notify your doctor if your symptoms worsen or if you experience persistent headache, persistent nausea, or bothersome infusion site reactions.
• For home infusion – This drug is administered by continuous subcutaneous (SC; beneath the skin) catheter, through an infusion pump. Carefully follow the storage, preparation, administration, and disposal techniques taught to you by your health care provider. Ensure that a backup infusion pump and subcutaneous infusion sets are readily available should a problem develop with the pump or infusion set you are using. Check infusion pump function and catheter frequently. Implement corrective actions as taught by your health care provider if a pump malfunction is noted or if the catheter becomes kinked or dislodged. Store at controlled room temperature (59 to 86°F).

Aggregation Inhibitors Information – Side Effects, Uses and Benefits

Type of Drug:

Antiplatelet agents.

How the Drug Works:

Platelets are components of the blood that aid in clot formation. Blood clots often form on platelets that have clumped together. These medicines help prevent blood clots from forming by preventing platelets from clumping together. In addition, cilostazol may dilate (widen) arteries in the legs to improve circulation.

Uses:

Cilostazol: To reduce the symptoms of intermittent claudication (eg, leg weakness, muscle pain, limping after walking) resulting in an increased walking distance before symptoms start.

Clopidogrel: To reduce the chances of stroke, heart attack, or death caused by blood clots in patients who have had a recent heart attack or stroke or who have peripheral arterial disease (hardening of the arteries or poor circulation).

To reduce the chances of heart attack, stroke, or death in patients with acute coronary syndrome (incomplete heart attack or rapidly worsening angina-type chest pain) who are going to be treated with medicines or heart surgery.

Ticlopidine: To reduce the risk of stroke caused by blood clots in patients who have experienced stroke precursors (eg, transient is chemic attacks, transient blindness, minor stroke), and in patients who have had a completed stroke caused by a blood clot. It is used in patients who are intolerant or allergic to aspirin therapy or have failed aspirin therapy for Broke prevention.

Unlabeled Uses: Occasionally doctors may prescribe triploid to improve blood flow in the lower extremities, reduce neurological deficit in patients with subtrahend hemorrhage, as an aid in open heart surgery, or as treatment of sickle cell disease or primary glomerulonephritis. Further studies are needed to establish usefulness in these situations.

Precautions:

Do not use in the following situations:

Use with caution in the following situations: gastrointestinal bleeding, history of kidney disease (ticlopidine only) liver disease trauma, surgery, or diseases that increase risk of bleeding ulcers, stomach or intestinal

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible hazards to the fetus.

Breastfeeding: It is not known if these drugs appear in breast milk. Because of the potential for adverse effects in a nursing infant, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Consult your doctor before you being breastfeeding.

Children: Safety and effectiveness have not been established. Lab tests are required during treatment with ticlopidine. Tests may include complete blood counts, platelet counts, and liver function tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications or dietary supplements with these drugs. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with these drugs:

• Aspirin macrolide antibiotics (eg, azole antifungals rythromycin)
• Omeprazole (eg, Prilosec)
• Hydantoins (eg, phenytoin)
• Warfarin (eg, Coumadin)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Circulatory System: Pounding in the chest (palpitations); fast heartbeat; chest pain; high blood pressure.

Nervous System: Headache; depression; dizziness; fatigue; feeling of whirling motion (vertigo).

Skin: Rash; bruising; itching; bleeding under the skin; skin disorder. Digestive Tract: Diarrhea; nausea; indigestion; stomach pain; vomiting; gas; appetite loss; light-colored stool; constipation; bleeding ulcer.

Urinary and Reproductive Tract: Dark urine; blood in urine; urinary tract infection.

Respiratory System: Upper respiratory infection; difficulty breathing; bronchitis; increased cough; runny nose; nosebleed; sore throat.

Other: Abnormal blood counts; yellow skin or eyes; sore throat; back, joint, muscle, or body pain; infection; swelling of the arms or legs; bleeding in the brain; swelling; weakness; accidental injury; flu-like symptoms; abnormal lab tests (eg, liver function).

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Take cilostazol at least 30 minutes before or 2 hours after meals.
• Take clopidrogel without regard to food. Take with food if stomach upset occurs.
• Take ticlopidine with food or just after eating to minimize stomach discomfort and increase absorption of the drug.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• It may take a few weeks for cilostazol to start working. Treatment for up to 12 weeks may be required before walking-distance benefits are experienced.
• Contact your doctor immediately if you experience any signs of infection such as fever, chills, or sore throat.
• It may take longer than usual to stop bleeding when taking these drugs. Report any unusual bleeding, bruising, or dark-colored stool to your doctor.
• Tell your dentist or doctor that you are taking one of these drugs before any surgery is scheduled (including tooth extraction) and before any new drug is prescribed.
• Notify your doctor immediately if you are taking ticlopidine and experience severe or persistent diarrhea, seizures, rashes, pinpoint bleeding beneath the skin, bleeding from the nose or gums, pale color, weak­ness on a side of the body, difficulty speaking, or any signs of liver damage such as yellow skin or eyes, dark urine, or light-colored stool.
• Lab tests will be required to monitor therapy with ticlopidine. Be sure to keep appointments.
• Store at controlled room temperature (59° to 86°F).

Aggregation Inhibitors-Vasodilators Drug – How does Aggregation Inhibitors-Vasodilators Works?

Type of Drug:

Antiplatelet agent; pulmonary artery vasodilator.

How the Drug Works:

Pulmonary artery hypertension is excessive blood pressure in the pulmonary arteries (arteries in the lung). Treprostinil dilates (widens) pulmonary arteries and reduces elevated blood pressure in the pulmonary arteries. It also keeps platelets (blood cells that aid in blood clot formation) from clumping together.

Uses:

For the treatment of pulmonary arterial hypertension (PAH) in patients with New York Heart Association (NYHA) Class II through IV symptoms to reduce symptoms (eg, difficulty breathing, chest pain, fatigue) associated with exercise.

Precautions:

Do not use in the following situations: Allergy to the drug or any of its ingredients.

Use with caution in the following situations: kidney disease liver disease

• Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible risks to the fetus.

• Breastfeeding: It is not known if treprostinil appears in breast milk. Consult your doctor before you begin breastfeeding.

• Children: Safety and effectiveness in children younger than 16 years of age have not been established.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications or dietary supplements with this drug. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with this drug:

• Anticoagulants (eg, warfarin)
• Blood pressure-reducing agents (eg, diuretics, antihypertensivo agents, vasodilators)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include: Circulatory System: Low blood pressure; widening of the blood vessels (vasodilation) .

Other: Infusion site reaction (eg, redness, hardness, induration, rash); infusion site pain, bleeding, or bruising; headache; rash; jaw pain; itching; dizziness; diarrhea; nausea.

Guidelines for Use:

• This medicine will usually be prepared and administered by your health care provider in a medical setting, but may be administered at home if your doctor feels it is safe to do so.
• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• If medicine needs to be stopped, the dose will usually be slowly reduced before being stopped completely.
• Notify your doctor if your symptoms worsen or if you experience persistent headache, persistent nausea, or bothersome infusion site reactions.
• For home infusion – This drug is administered by continuous subcutaneous (SC; beneath the skin) catheter, through an infusion pump. Carefully follow the storage, preparation, administration, and disposal techniques taught to you by your health care provider. Ensure that a backup infusion pump and subcutaneous infusion sets are readily available should a problem develop with the pump or infusion set you are using. Check infusion pump function and catheter frequently. Implement corrective actions as taught by your health care provider if a pump malfunction is noted or if the catheter becomes kinked or dislodged. Store at controlled room temperature (59 to 86°F).