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Iloprost dosing for frostbite

Iloprost dosing for frostbite
  Initial dose (ng/kg/minute)* Dose titration
Days 1 to 3 0.5 ng/kg/minute IV for 30 minutes Increase infusion rate by 0.5 ng/kg/minute every 30 minutes as toleratedΔ up to a maximum rate of 2 ng/kg/minute. Administer highest tolerated rate (up to 2 ng/kg/minute) for remainder of 6-hour infusion.
Days 4 to 8 Restart at highest tolerated infusion rate from previous day up to a maximum rate of 2 ng/kg/minute. Decrease the dose if non-tolerable adverse reaction occursΔ.
For use in conjunction with UpToDate content on acute care of frostbite. In patients with impaired kidney and/or hepatic function, may use a reduced initial infusion rate of 0.25 ng/kg/minute; refer to Lexidrug monograph included within UpToDate.

IV: intravenous; ng: nanograms.

* Doses are based on actual (total) body weight. There are no specific data to guide treatment in children; UpToDate recommends treating frostbite in children as in adults.

¶ Administer intravenous infusion over 6 hours each day for 8 consecutive days via a programmable electronic infusion pump or syringe driver that meets requirements for minimal and maximal volume delivery rates; refer to Lexidrug monograph for specific requirements.

Δ If non-tolerable adverse reaction (eg, headache, hypotension, tachycardia, flushing, jaw pain, nausea, vomiting, dizziness) occurs, decrease the dose by 0.5 ng/kg/minute every 30 minutes, until a tolerated dose is reached. If the infusion is stopped due to dose-limiting adverse event, the infusion can be restarted at a previously tolerated dose once the event has resolved.

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