Drug Database
EP

epoprostenol (Caripul)

✓ Approved

Actelion · PTGIR · Small Molecule

What is epoprostenol?

epoprostenol is a small molecule developed by Actelion. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesCaripul
CompanyActelion
Drug ClassSmall Molecule
Molecular TargetPTGIR
RouteInjectable (Others), Intravenous (IV)
StatusApproved
Sources: ClinicalTrials.gov, Actelion

Mechanism of Action

Molecular Targets

epoprostenol acts on 1 molecular target:

PTGIRprostaglandin I2 receptor (IP, PRIPR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

epoprostenol is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Respiratory, thoracic and mediastinal disordersPulmonary hypertension✓ Approved

Related Research Articles

PubMedHospital pharmacy2026-05-22

Hypotensive Events Associated With PDE-5 Inhibitors in Pulmonary Arterial Hypertension: Assessment of the USFDA Adverse Event Reporting System Using Disproportionality and Interaction Analysis.

Sridharan Kannan K, Sivaramakrishnan Gowri G

Phosphodiesterase-5 inhibitors (PDE-5is) are fundamental in pulmonary arterial hypertension (PAH) treatment, often used in combination with other therapeutic agents. However, hypotension signals associated with these combinations remain inadequately characterized. We analyzed the United States Food and Drug Administration Adverse Event Reporting System (FAERS) to evaluate disproportionate signals of hypotension associated with PDE-5is alone and in combination therapy. We conducted a pharmacovigilance analysis of FAERS data from 2004 to 2024, employing both frequentist (reporting odds ratio, proportional reporting ratio) and Bayesian (information component, empirical Bayes geometric mean) approaches. Interaction signal scores (INTSS) were calculated to assess potential drug interactions between PDE-5is and other PAH therapies. Clinical outcomes were evaluated for both monotherapy and combination regimens. Among 29 163 222 reports analyzed, 704 cases of PDE-5i-associated hypotension were identified (533 monotherapy, 171 combination therapy). While PDE-5i monotherapy showed no significant hypotension signals, combinations with endothelin antagonists (particularly bosentan) and prostacyclin analogs (notably epoprostenol) generated strong safety signals. Significant INTSS were detected for sildenafil and tadalafil with endothelin antagonists. Paradoxically, despite fewer hypotension reports, PDE-5i monotherapy was associated with higher rates of death and life-threatening events compared to combination therapy (P = .02). This analysis reveals significant hypotension signals with specific PDE-5i combinations in PAH treatment, particularly with endothelin antagonists and prostacyclin analogs. While combination therapy showed a higher frequency of hypotensive events, these episodes appeared more manageable than those occurring with monotherapy. These findings emphasize the need for careful monitoring and individualized risk assessment in PAH patients receiving PDE-5i-based therapy.

PMID 42170200
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PubMedPediatric nephrology (Berlin, Germany)2026-05-18

Novel use of the Nuwellis® dual extended length catheter (dELC) as umbilical venous access for neonatal kidney replacement therapy: case series.

Short Kara K, Umberger Alyssa A, Mathis Meggie M, Walker Mallory M et al.

Neonates with congenital kidney failure or acute kidney injury often require continuous kidney replacement therapy (CKRT). Historically, venous access for CKRT in this population has relied on non-approved adult catheters, commonly via the internal jugular (IJ) vein. Limited international reports describe using the umbilical vein for CKRT, but this practice is not widespread in the USA. The Nuwellis® dual lumen extended length catheter (dELC), originally created for adult ultrafiltration, may support alternative access for neonatal CKRT. This case series describes the clinical course of four neonates requiring CKRT using a 6 French Nuwellis® dELC placed in the umbilical vein at University of Iowa Stead Family Children's Hospital and Children's of Alabama. Patient demographics, CKRT prescriptions, access characteristics, and complications were reviewed. All four neonates underwent successful umbilical vein placement of the 6 Fr dELC. Weight at initiation ranged from 2.23 to 4.1 kg, with blood flow rates 20-40 mL/min. Epoprostenol anticoagulation was used in three patients. Half of the cohort later transitioned to a tunneled catheter, and one transitioned to an IJ catheter following fluid removal. One catheter developed hub cracks likely related to lumen caps, and one patient experienced flow limitations attributed to positioning rather than catheter function. Two patients had no catheter-related complications. Umbilical venous access using the 6Fr dELC may represent a viable alternative for neonatal CKRT. Coil reinforcement within the catheter may support patency and better functionality. Additional studies are needed to assess safety and broader applicability.

PMID 42149206
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PubMedTherapie2026-05-14

Descriptive study of the effects of treprostinil and/or epoprostenol in newborn infants with inhaled NO refractory persistent pulmonary hypertension of the newborn (PPHN).

Mazepa Charlotte C, Mur Sébastien S, Gascoin Géraldine G, Storme Laurent L et al.

Epoprostenol and treprostinil, prostacyclin analogues, are used in some neonatal intensive care units (NICU) in the treatment of persistent pulmonary hypertension of the newborn (PPHN) refractory to inhaled nitric oxide (iNO). The aim of this retrospective multicentric descriptive study was to assess the profile and evolution of these newborns. Inclusion of neonates born ≥ 34 weeks of gestational age (WGA) and aged ≤ 28 days of life, presenting clinical signs of PPHN (respiratory and/or hemodynamic lability), and at least one echocardiographic sign of pulmonary hypertension. We collected data on the use of prostacyclin analogues, their tolerance, and their efficacy, by collecting clinical, biological, and echocardiographic data of these newborns. Seventy patients were included from 4 French NICU. It appears that there may be an improvement in pulmonary hypertension (PH) at the initiation of prostacyclin analogues, showing by an increase in post-ductal SpO2, a decrease in FiO2 and an improvement in PH'level on echocardiography. Only four patients needed a treatment discontinuation due to poor hemodynamic tolerance. Our study highlighted the safety of the use of epoprostenol and treprostinil in neonates suffering from iNO refractory PPHN, without significant adverse effect. It appears to be necessary to carry out further study to establish recommendations for the management of PPHN, and also to define more precisely the place of treprostinil and epoprostenol in this pathology.

PMID 42128749
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PubMedCardiovascular toxicology2026-04-13

A Real-World Disproportionality Analysis of Drug-Induced Heart Failure: Integrating FAERS Database and AHA Statement.

Li Da D, Dong Yidan Y, Yao Lei L, Chen Xiaozhe X et al.

Heart failure (HF), the advanced stage of diverse cardiac conditions, poses a significant public health challenge. This study analyzes adverse event (AE) signals associated with HF within the FDA Adverse Event Reporting System (FAERS) database, offering critical insights to guide rational medication use in clinical settings. Adverse event reports (AERs) associated with HF in the FAERS database, spanning from the first quarter of 2004 to the fourth quarter of 2024, were analyzed. The potential HF risk of drugs was assessed using the disproportionality analysis, with findings juxtaposed against the American Heart Association (AHA) drug list. Drug-induced HF cases showed equivalent distribution between male and female, and high rates of rehospitalization and mortality. Prominent hypoglycemic drugs associated with HF included rosiglitazone, pioglitazone, and saxagliptin. Combination therapies, such as metformin/saxagliptin and metformin/rosiglitazone, also demonstrated elevated risks. In the context of pulmonary hypertension, drugs like macitentan, selexipag, and epoprostenol were particularly notable. Analysis against the AHA drug list confirmed stronger signal strength and frequency among Class A drugs, validating our results. Furthermore, drugs not flagged as positively signaling in the AHA registry, such as amiodarone, aliskiren, and testosterone, merit closer scrutiny due to their potential for adverse reactions. Our analysis of the FAERS database has identified medications associated with potential HF risks, providing valuable evidence to inform clinical decision-making and promote the safe use of medications.

PMID 41968208
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PubMedPulmonary circulation2026-04-08

Lifesaving Compassionate-Use of Sotatercept in a 12-Year-old With Idiopathic Pulmonary Arterial Hypertension.

Pelczar-Płachta Weronika W, Surmacz Rafał R, Bobkowski Waldemar W

Pediatric idiopathic pulmonary arterial hypertension (IPAH) refractory to maximal medical therapy is associated with high morbidity and mortality, and therapeutic options remain limited. We describe a 12-year-old girl with end-stage IPAH who developed acute decompensated right heart failure despite triple combination therapy, including high-dose prostacyclin. Escalation to intravenous epoprostenol failed to result in clinical or hemodynamic improvement. Following multidisciplinary discussion, ethical approval, and informed consent, sotatercept was initiated under compassionate use. Sotatercept therapy resulted in rapid and marked clinical recovery, including improvement in World Health Organization functional class (WHO FC) from IV to II, substantial increase in 6-min walk distance, normalization of NT-proBNP levels, and significant echocardiographic and invasive hemodynamic improvement. This case highlights the potential role of sotatercept as a rescue therapy in pediatric IPAH refractory to conventional treatment.

PMID 41948511
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PubMedReports (MDPI)2026-03-27

Rapid Onset of Pulmonary Arterial Hypertension After Liver Transplant-A Case Report.

Redaelli Simone S, Nazemian Ryan R, Hackl Florian F, Uthayashankar Arun A et al.

Background and Clinical Significance: Pulmonary hypertension (PH) is a recognized complication of chronic liver disease, most commonly manifesting as portopulmonary hypertension (POHP) prior to liver transplantation. While the natural history and management of pre-transplant PH are well described, the development of de novo pulmonary arterial hypertension (PAH) following liver transplantation remains exceedingly rare and poorly understood. In such cases, establishing true causality is challenging, and alternative explanations-including previously unrecognized or masked disease-must be carefully considered. This entity poses significant diagnostic and therapeutic challenges and may adversely affect post-transplant outcomes if not promptly recognized and treated. Case Presentation: We report the case of a 46-year-old man with end-stage liver disease secondary to alcohol use who underwent deceased donor liver transplantation without preoperative evidence of PH. His pre-transplant evaluation revealed preserved biventricular function and no measurable PH. Eight days postoperatively, he was readmitted with acute dyspnea, hypoxemia, and signs of right ventricular failure. Transthoracic echocardiography demonstrated severe right ventricular dilation and dysfunction with markedly elevated pulmonary artery systolic pressure. Right heart catheterization confirmed severe PAH. Secondary causes of PH were excluded. The patient was initiated on sildenafil and continuous intravenous epoprostenol, resulting in clinical, echocardiographic, and hemodynamic improvement. Subsequent follow-up demonstrated sustained response to therapy despite concurrent progression of coronary artery disease requiring complex percutaneous intervention. Conclusions: This case highlights a rare presentation of severe PAH occurring shortly after liver transplantation, in the absence of documented pre-transplant PH. While a causal relationship cannot be definitively established, the temporal association raises important clinical considerations. It underscores the need for heightened clinical vigilance for pulmonary vascular disease in post-transplant patients presenting with cardiopulmonary symptoms. Further research is warranted to elucidate the underlying mechanisms, risk factors, and optimal management strategies for PAH diagnosed after liver transplantation.

PMID 41893444
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