Skip to Content

Epoprostenol Side Effects

In Summary

Commonly reported side effects of epoprostenol include: agitation, anxiety, chest pain, headache, hypotension, nausea, nervousness, vomiting, and flushing. Other side effects include: abdominal pain, bradycardia, and dizziness. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to epoprostenol: intravenous powder for solution

Along with its needed effects, epoprostenol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking epoprostenol:

More common
  • Abdominal or stomach pain
  • arm, back, or jaw pain
  • bladder pain
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • bloody or cloudy urine
  • blurred vision
  • changes in skin color
  • chest congestion
  • chest pain or discomfort
  • chest tightness or heaviness
  • chills
  • cold hands and feet
  • confusion
  • constipation
  • convulsions
  • cough or hoarseness
  • coughing up blood
  • decreased urine
  • depression
  • diarrhea
  • difficult, burning, or painful urination
  • difficulty with breathing or swallowing
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • extreme fatigue
  • fast, pounding, or irregular heartbeat or pulse
  • feeling of warmth
  • fever
  • headache
  • incoherent speech
  • increased menstrual flow or vaginal bleeding
  • increased thirst
  • increased urination
  • local infection at the catheter site
  • loss of appetite
  • metallic taste
  • muscle pain or cramps
  • muscle weakness
  • nausea or vomiting
  • nosebleeds
  • numbness or tingling in the hands, feet, or lips
  • pain at the injection site
  • pain, redness, or swelling in the arm or leg
  • paleness of the skin
  • prolonged bleeding from cuts
  • rapid weight gain
  • red or black, tarry stools
  • redness of the face, neck, arms, and occasionally, upper chest
  • sweating
  • swelling of the face, fingers, feet, or lower legs
  • tightness in the chest
  • tingling of the hands or feet
  • unusual tiredness or weakness
  • weight gain or loss
Less common
  • Altered or abnormal touch sensation or sensitivity
  • blue lips and fingernails
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • coughing that sometimes produces a pink frothy sputum
  • difficult, fast, or noisy breathing
  • inability to speak
  • increased sweating
  • numbness or tingling in the hands, feet, or lips
  • pain or discomfort in the arms, jaw, back, or neck
  • seizures
  • severe or sudden headache
  • severe pain in the chest
  • slurred speech
  • sudden onset of severe breathing
  • temporary blindness
  • weakness in the arm or leg on one side of the body, sudden and severe
  • weakness or heaviness of the legs
Incidence not known
  • Feeling of fullness
  • high fever
  • pinpoint red spots on the skin
  • sensitivity to heat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • trouble sleeping
  • troubled breathing with exertion

Some side effects of epoprostenol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Change in vision
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • heartburn
  • hives or welts
  • impaired vision
  • itching
  • joint pain
  • lack of appetite
  • lack or loss of strength
  • loss of interest or pleasure
  • muscle pains or stiffness
  • redness of the skin
  • shakiness in the legs, arms, hands, or feet
  • skin rash, encrusted, scaly and oozing
  • sores on the skin
  • swollen joints
  • tiredness
  • trembling or shaking of the hands or feet
  • trouble concentrating
Less common
  • Acid or sour stomach
  • belching
  • blurred vision or other changes in vision
  • excess air or gas in the stomach or intestines
  • indigestion
  • leg cramps
  • passing gas
  • sleepiness or unusual drowsiness
  • stomach discomfort or upset

For Healthcare Professionals

Applies to epoprostenol: intravenous powder for injection


The most frequently reported side effects during initiation and dose escalation were nausea, vomiting, headache, hypotension, flushing, chest pain, anxiety, dizziness, bradycardia, dyspnea, abdominal pain, musculoskeletal pain, and tachycardia.

The most frequently reported side effects during chronic dosing were jaw pain, headache, flushing, diarrhea, nausea, vomiting, flu-like symptoms, and anxiety/nervousness.[Ref]


Very common (10% or more): Palpitation (63%), flushing (up to 58%), cyanosis (up to 54%), tachycardia (up to 35%), pallor (up to 32%), hypotension (up to 27%), right heart failure (up to 25%), heart failure (23%)
Common (1% to 10%): Bradycardia, myocardial infarction, shock, peripheral vascular disorder, vascular disorder[Ref]

Nervous system

Very common (10% or more): Dizziness (up to 83%), headache (up to 83%), tremor (21%), hyperkinesia (up to 21%), syncope (up to 13%), hypesthesia (up to 12%), paresthesia (up to 12%), hyperesthesia (12%)[Ref]


Very common (10% or more): Nausea/vomiting (up to 67%), esophageal reflux/gastritis (61%), diarrhea (up to 50%), ascites (up to 23%)
Common (1% to 10%): Abdominal pain, dyspepsia, abdominal colic
Uncommon (0.1% to 1%): Dry mouth[Ref]


Very common (10% or more): Pain/neck pain/arthralgia (up to 84%), nonspecific musculoskeletal pain (up to 84%), jaw pain (up to 75%), myalgia (44%)
Common (1% to 10%): Back pain, leg cramp
Frequency not reported: Collagen disease[Ref]


Very common (10% or more): Weight decreased (45%), pain (up to 29%), chills/fever/sepsis/flu-like symptoms (25%), fever (21%), hemorrhage/ hemorrhage injection
site/ hemorrhage rectal (11%), chest pain (11%)
Common (1% to 10%): Asthenia, sepsis, septicemia, procedural complication
Very rare (less than 0.01%): Lassitude
Frequency not reported: Fatigue, edema, catheter-related infection[Ref]


Common (1% to 10%): Thrombocytopenia, bleeding
Postmarketing reports: Anemia, hypersplenism, pancytopenia, splenomegaly[Ref]


Very rare (less than 0.01%): Hyperthyroidism[Ref]


Very common (10% or more): Hypoxia (up to 55%)
Common (1% to 10%): Dyspnea, pneumothorax, hemothorax, cough increased, epistaxis, pharyngitis, pleural effusion, sinusitis, pulmonary edema, respiratory disorder
Postmarketing reports: Pulmonary embolism[Ref]


Very common (10% or more): Infection (18%), pain (up to 13%)
Very rare (less than 0.01%): Erythema[Ref]


Very common (10% or more): Anxiety/nervousness (up to 21%), depression (up to 13%), agitation (11%)
Common (1% to 10%): Insomnia
Postmarketing reports: Acute confusional state[Ref]


Very common (10% or more): Skin ulcer (39%), eczema/rash/urticaria (up to 25%)
Common (1% to 10%): Sweating, cellulitis[Ref]


Common (1% to 10%): Hematuria, urinary tract infection[Ref]


Postmarketing reports: Hepatic failure[Ref]


Very common (10% or more): Anorexia (up to 66%)
Common (1% to 10%): Hyperkalemia, hypercalcemia
Frequency not reported: Blood glucose increased[Ref]


1. "Product Information. Epoprostenol Sodium (epoprostenol)." Teva Pharmaceuticals USA, North Wales, PA.

2. "Product Information. Flolan (epoprostenol)." Glaxo Wellcome, Research Triangle Park, NC.

3. Cerner Multum, Inc. "Australian Product Information." O 0

4. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

5. "Product Information. Veletri (epoprostenol)." Actelion Pharmaceuticals US Inc, South San Francisco, CA.

Some side effects of epoprostenol may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.