2018
DOI: 10.1177/1060028018776432
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Effectiveness, safety, and Economic Comparison of Two Inhaled Epoprostentol Products (Flolan and Veletri) in Cardiothoracic Surgery Patients

Abstract: Inhaled Veletri was demonstrated to be non-inferior to inhaled Flolan when comparing change in PaO/FiO ratio 1 hour post -therapy initiation,and inhaled Veletri was an acceptable alternative to inhaled Flolan in a cardiothoracic surgery patient population.

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Cited by 8 publications
(16 citation statements)
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“…However, through manual chart review we did not find any mention of increased intolerance or airway inflammation with inhaled Veletri therapy, which is in line with the findings from other studies that have evaluated inhaled Veletri use in an adult patient population. 7,19 Finally, more patients who received inhaled Veletri developed thrombocytopenia and required platelet transfusions than patients who received inhaled Flolan, but patients who received inhaled Veletri had significantly lower platelet counts at baseline, and we believe that this is unlikely to be an effect of Veletri.…”
Section: Discussionmentioning
confidence: 87%
See 1 more Smart Citation
“…However, through manual chart review we did not find any mention of increased intolerance or airway inflammation with inhaled Veletri therapy, which is in line with the findings from other studies that have evaluated inhaled Veletri use in an adult patient population. 7,19 Finally, more patients who received inhaled Veletri developed thrombocytopenia and required platelet transfusions than patients who received inhaled Flolan, but patients who received inhaled Veletri had significantly lower platelet counts at baseline, and we believe that this is unlikely to be an effect of Veletri.…”
Section: Discussionmentioning
confidence: 87%
“…Patients who received inhaled Veletri had a shorter duration of mechanical ventilation, less frequent dialysis initiation, and a decreased cost per median duration of inhaled epoprostenol compared with patients who received inhaled Flolan. 19 The differences in secondary outcomes were attributed to a change in practice at their institution rather than to differences between inhaled epoprostenol formulations. The lack of inclusion of ARDS patients in the study makes the extrapolation of these findings to our study limited.…”
Section: Discussionmentioning
confidence: 99%
“…60,[74][75][76]78 The epoprostenol product, Veletri, has a theoretically greater risk of bronchospasm compared to the Flolan product due to the arginine component in the inactive ingredients of Veletri, although this has not been reported when Veletri has been studied in critically ill patients. 80,81 There is an increased potential for medication errors when prescribing, preparing, and administering epoprostenol via the inhalation route since it is an IV product. Special safety measures should be taken to prevent inadvertent IV administration.…”
Section: Inhaled Formulationsmentioning
confidence: 99%
“…63 Administration of iEPO (Veletri) exposes patients to increased concentrations of arginine, potentially leading to bronchospasm and respiratory distress; however, in recent studies, the effects of Flolan and Veletri were comparable in regard to improvements in PaO 2 :FiO 2 without differences in risks. 78,79 Dosing of iEPO has been described as a fixed-dose or weight-based dose by ideal body weight. A fixed-dose strategy requires a change in concentration for each dose titration, whereas a weight-based dosing strategy offers the convenience of a standardized concentration with dose titration allowed by changing the rate and gas flow to the nebulizer.…”
Section: Inhaled Pulmonary Vasodilators Impact On Oxygenation Parametmentioning
confidence: 99%
“…63 Administration of iEPO (Veletri) exposes patients to increased concentrations of arginine, potentially leading to bronchospasm and respiratory distress; however, in recent studies, the effects of Flolan and Veletri were comparable in regard to improvements in PaO 2 :FiO 2 without differences in risks. 78,79…”
Section: Inhaled Pulmonary Vasodilatorsmentioning
confidence: 99%