Medical Health Encyclopedia

Vasodilators help to open blood vessels and relieve pressure in pulmonary arteries. Vasodilators used to treat pulmonary hypertension fall into several different drug classes:

Calcium Channel Blockers (CCBs). Some patients with pulmonary hypertension benefit from CCBs. These drugs help relax blood vessels in the heart and lungs and increase the supply of oxygen. However, CCBs are only appropriate for patients who meet certain diagnostic criteria including absence of right-sided heart failure.

Prostaglandins (Prostacyclins). Prostaglandins (also called prostacyclins), which open blood vessels, are now the primary agents for treating pulmonary hypertension.

• Iloprost (Ventavis) is available in inhaled and intravenous forms. Studies suggest that the inhaled form improves exercise capacity and survival in some patients with pulmonary hypertension. In addition, infusions of iloprost remain effective over long periods (up to three years) of use.
• Treprostinil (Remodulin) is similar to epoprostenol but is more stable. It can also be administered using a portable pump that delivers the drug under the skin. This is less expensive, cumbersome, and invasive than the delivery methods for epoprostenol.
• Epoprostenol (Flolan), which is administered intravenously, has improved exercise capacity and symptoms in both the short and long term in a number of patients. In some patients, survival is increased significantly. However, not all patients respond to this agent. The implanted catheter needed to deliver the agent can also cause serious complications.

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Endothelin Receptor Antagonists. Bosentan (Tracleer) was the first oral agent approved for pulmonary hypertension. Bosentan controls endothelin, a powerful molecule that causes blood vessels to narrow. Studies have reported improved exercise capacity in patients with pulmonary hypertension.