EPOPROSTENOL IS GIVEN BY CONTINUOUS INTRAVENOUS INFUSION OR INTO THE BLOOD SUPPLYING THE EXTRACORPOREAL CIRCULATION. THE USUAL DOSE FOR RENAL DIALYSIS IS 4 NANOGRAMS/KG PER MINUTE INTRAVENOUSLY BEFORE DIALYSIS, THEN 4 NANOGRAMS/KG PER MINUTE INTO THE ARTERIAL INLET OF THE DIALYSER DURING DIALYSIS.
IN THE LONG-TERM TREATMENT OF PRIMARY PULMONARY HYPERTENSION A DOSE-RANGING PROCEDURE IS PERFORMED FIRST. EPOPROSTENOL INFUSION IS STARTED AT A RATE OF 2 NANOGRAMS/KG PER MINUTE, THEN INCREASED BY INCREMENTS OF 2 NANOGRAMS/KG PER MINUTE AT INTERVALS OF AT LEAST 15 MINUTES UNTIL THE MAXIMUM HAEMODYNAMIC BENEFIT OR DOSE-LIMITING EFFECTS OCCUR. EPOPROSTENOL IS THEN GIVEN BY CONTINUOUS INFUSION THROUGH A CENTRAL VENOUS CATHETER, THE INITIAL RATE BEING 4 NANOGRAMS/KG PER MINUTE LESS THAN THE MAXIMUM-TOLERATED INFUSION RATE; IF THE MAXIMUM-TOLERATED INFUSION RATE IS LESS THAN 5 NANOGRAMS/KG PER MINUTE, THEN THE INITIAL RATE SHOULD BE ONE-HALF OF THIS MAXIMUM RATE.