ProstazyklinAnaloga

Prostacyclin analogs are a class of drugs that imitate prostacyclin (prostacyclin I2), a potent vasodilator and inhibitor of platelet aggregation produced by the vascular endothelium. They act primarily on the prostacyclin IP receptor, activating adenylate cyclase and raising intracellular cAMP, which leads to relaxation of vascular smooth muscle and reduced platelet activation.

These agents vary in stability and route of administration. Epoprostenol, the natural prostacyclin analogue, requires continuous intravenous infusion because of a very short half-life. Iloprost is commonly given by inhalation, providing pulmonary vasodilation with limited systemic effects. Treprostinil can be delivered subcutaneously or intravenously and can also be inhaled, with a longer half-life than epoprostenol. Beraprost is an oral analogue used in some countries for PAH and peripheral vascular indications.

Selexipag is a related medication that acts as a non-prostanoid agonist of the IP receptor; while it produces similar therapeutic effects, it is not a prostacyclin analog in the strict sense. Prostacyclin analogs are primarily indicated for pulmonary arterial hypertension (PAH), including idiopathic and connective tissue disease–associated PAH, and may be used in other forms of pulmonary hypertension depending on jurisdiction.

Adverse effects commonly reflect vasodilation and anti-platelet activity and include hypotension, flushing, headache, jaw pain, and cough (especially with inhaled forms). Other effects include edema, diarrhea or nausea, jaw fatigue, and pain at infusion sites for subcutaneous treprostinil. Serious bleeding risk may arise from impaired platelet aggregation.

Development of prostacyclin analogs expanded PAH management by providing longer-acting and more easily administered options, though they require careful monitoring for hypotension and infusion-related complications.