Duration of treatment - up to 4 weeks.
Ilomedin should be used only in conditions of careful monitoring monitoring in hospitals or outpatient facilities that have the appropriate technical capabilities.
Before starting treatment, women should be excluded from pregnancy. Ilomedin should be used only after dilution. The solution must be freshly prepared.
The contents of the ampoule and the solvent must be thoroughly mixed.
Breeding
It is necessary to strictly follow the dilution method, depending on the method of administration of the solution.
When using an infusion pump (infusion pump)
Ampoule contents 1 ml concentrate for solution for infusion dilute with sterile 0.9% sodium chloride solution or 5% glucose solution (dextrose) for injection to a volume of 100 ml.
Ampoule content 2.5 ml concentrate for solution for infusion diluted with sterile 0.9% sodium chloride solution or 5% glucose solution (dextrose) for injection to a volume of 250 ml.
When using an automatic syringe
Contents of the ampoule 1 ml of concentrate for the preparation of the solution for infusion is diluted with a sterile 0.9% solution of sodium chloride or 5% glucose solution (dextrose) for injections up to a volume of 10 ml.
Ampoule content 2.5 ml concentrate for solution for infusion diluted with sterile 0.9% sodium chloride solution or 5% glucose solution (dextrose) for injection to a volume of 25 ml.
After breeding, Ilomedin is administered daily as a 6-hour infusion into the peripheral vein or a catheter installed in the central vein. The rate of administration (dose) depends on individual tolerability and is 0.5-2.0 ng per kg of body weight per minute. It is necessary to control blood pressure and heart rate at the beginning of the infusion and at each increase in the dose of the drug.
During the first 2-3 days, individual tolerance of the drug is determined - treatment is started at a rate of 0.5 ng / kg / min for 30 minutes. After this, the dose is incrementally incremented by 0.5 ng / kg / min approximately every 30 minutes. The exact infusion rate is calculated based on body weight at the maximum tolerated dose in the range of 0.5 to 2.0 ng / kg / min. (cm.below, tables of infusion rate when using an infusomat or automatic syringe).
Depending on the frequency of such side effects, such as headache, nausea or a decrease in blood pressure, the infusion rate should be reduced to the maximum tolerable. With the development of severe side effects, infusion should be interrupted. Treatment should be continued usually within 4 weeks, applying doses that were well tolerated in the first 2-3 days of the previous course of treatment.
The infusion rate (ml / h) for the administration of various doses when using an infusomat (infusion pump)
The following table can be used to calculate the infusion rate corresponding to the body weight of a particular patient and the dose to be administered.
| Body weight (kg) | Dose (ng / kg / min) |
|
| 0,5 | 1,0 | 1,5 2,0 |
|
| Speed andnf(ml / h) |
| 40 | 6,0 | 12 | 18,0 | 24 |
| 50 | 7,5 | 15 | 22,5 | 30 |
| 60 | 9,0 | 18 | 27,0 | 36 |
| 70 | 10,5 | 21 | 31,5 | 42 |
| 80 | 12,0 | 24 | 36,0 | 48 |
| 90 | 13,5 | 27 | 40,5 | 54 |
| 100 | 15,0 | 30 | 45,0 | 60 |
| 110 | 16,5 | 33 | 49,5 | 66 |
Infusion rate (ml / h) for administration of various doses using an automatic syringe
The following table can be used to calculate the infusion rate corresponding to the body weight of a particular patient and the dose to be administered.
| Body mass, kg | Dose (ng / kg / min) |
|
| 0,5 | 1,0 | 1,5 | 2,0 |
|
| Infusion rate (ml / h) |
| 40 | 0,60 | 1,2 | 1,80 | 2,4 |
| 50 | 0,75 | 1,5 | 2,25 | 3,0 |
| 60 | 0,90 | 1,8 | 2,70 | 3,6 |
| 70 | 1,05 | 2,1 | 3,15 | 4,2 |
| 80 | 1,20 | 2,4 | 3,60 | 4,8 |
| 90 | 1,35 | 2,7 | 4,05 | 5,4 |
| 100 | 1,50 | 3,0 | 4,50 | 6,0 |
| 110 | 1,65 | 3,3 | 4,95 | 6,6 |
In patients with systemic scleroderma suffering from Raynaud's syndrome,to achieve an improvement lasting several weeks, often a shorter course of treatment (3-5 days) is sufficient.
It is not recommended to perform continuous infusions for several days because of the possibility of developing tachyphylaxis, expressed in a weakened effect on platelets, and the possibility of a "rebound" syndrome, manifested in an increase in the propensity to aggregate platelets at the conclusion of the course of therapy. However, there are no reports of any clinical complications associated with these phenomena.
With renal failure requiring dialysis, and with liver cirrhosis, the removal of iloprost is reduced. In these cases, it is necessary to reduce the recommended dose by 2 times.