Ventavis (iloprost)
An approved treatment for Pulmonary Arterial Hypertension.
The same compound appears under different names depending on the context. Here is how to identify Iloprost wherever you encounter it, plus the key facts at a glance.
- Generic name
- Iloprost
- Brand name
- Ventavis
- Drug class
- Prostacyclin analog (inhaled)
- Manufacturer
- Actelion / Janssen
- How it's taken
- Inhaled 6-9 times daily while awake, using only the nebulizer system named on the product label (the Ventavis label specifies the I-neb AAD System and warns that other systems may not give the right dose).
An inhaled prostacyclin therapy for adults with PAH (WHO Group 1) that delivers medication directly to the lungs. It has not been studied in children. By targeting the pulmonary vessels specifically, Ventavis avoids many of the systemic side effects of IV prostacyclins. Brand Ventavis has been discontinued in the US; FDA approved a generic iloprost inhalation solution in July 2026. Ask your PAH care team what is currently available to you.
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Where Iloprost fits
Inhaled prostacyclin for PAH, providing targeted pulmonary vasodilation with fewer systemic side effects than IV prostacyclins. Often used as add-on therapy.
How Iloprost works
Iloprost works the same way as epoprostenol, relaxing blood vessels and preventing clots by mimicking prostacyclin. The difference is delivery: by inhaling it as a mist, the drug goes directly to the lung blood vessels where it's needed. This means more drug reaches the target and less circulates through the rest of the body, reducing side effects like flushing and jaw pain.
Mechanism: Inhaled synthetic prostacyclin analog that selectively dilates pulmonary blood vessels with minimal systemic effects
Side effects and safety
Cough and flushing are the most common side effects. Headache, jaw pain, and low blood pressure can occur but are generally milder than with IV prostacyclins. Bronchospasm is possible, especially in patients with reactive airway disease. Iloprost can lower blood pressure enough to cause fainting, so vital signs are checked when starting, and it should not be started if systolic blood pressure (the top number) is below 85 mmHg. Stop treatment and get medical help right away if signs of fluid in the lungs (pulmonary edema) appear, because this may be a sign of pulmonary venous hypertension. Iloprost can also raise the risk of bleeding, especially in people taking blood thinners. Each inhalation session takes 5-15 minutes.
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Iloprost
Inhaled 6-9 times daily while awake, using only the nebulizer system named on the product label (the Ventavis label specifies the I-neb AAD System and warns that other systems may not give the right dose). Each treatment takes about 5-15 minutes. The frequent dosing schedule is the main inconvenience. Typically used as add-on therapy to oral PAH medications.
Availability and cost
Generic versions may be available at a lower cost. Ask your pharmacist.
Inhaled prostacyclin analog requiring 6-9 nebulization sessions daily. The specialized delivery system and frequent dosing schedule contribute to overall costs.
Clinical trial results
The AIR trial showed significant improvement in 6-minute walk distance and NYHA functional class versus placebo in patients already on conventional therapy.
Development history
Approved by FDA in December 2004. Offered a middle ground between oral therapies and continuous IV prostacyclins. The inhaled route was an innovation that expanded prostacyclin use to patients who didn't yet need IV therapy. Often used in combination with oral PAH drugs. Brand Ventavis was later discontinued in the US (FDA recorded that it was not withdrawn for safety or effectiveness reasons), and FDA approved a generic iloprost inhalation solution on July 10, 2026.
Explore Pulmonary Arterial Hypertension trials
Other Pulmonary Arterial Hypertension treatments
Common questions about Iloprost
▸What is Iloprost (Ventavis)?
An inhaled prostacyclin therapy for adults with PAH (WHO Group 1) that delivers medication directly to the lungs. It has not been studied in children. By targeting the pulmonary vessels specifically, Ventavis avoids many of the systemic side effects of IV prostacyclins. Brand Ventavis has been discontinued in the US; FDA approved a generic iloprost inhalation solution in July 2026. Ask your PAH care team what is currently available to you.
▸How does Iloprost work?
Iloprost works the same way as epoprostenol, relaxing blood vessels and preventing clots by mimicking prostacyclin. The difference is delivery: by inhaling it as a mist, the drug goes directly to the lung blood vessels where it's needed. This means more drug reaches the target and less circulates through the rest of the body, reducing side effects like flushing and jaw pain.
▸What are the side effects of Iloprost?
Cough and flushing are the most common side effects. Headache, jaw pain, and low blood pressure can occur but are generally milder than with IV prostacyclins. Bronchospasm is possible, especially in patients with reactive airway disease. Iloprost can lower blood pressure enough to cause fainting, so vital signs are checked when starting, and it should not be started if systolic blood pressure (the top number) is below 85 mmHg. Stop treatment and get medical help right away if signs of fluid in the lungs (pulmonary edema) appear, because this may be a sign of pulmonary venous hypertension. Iloprost can also raise the risk of bleeding, especially in people taking blood thinners. Each inhalation session takes 5-15 minutes.
▸How is Iloprost taken?
Inhaled 6-9 times daily while awake, using only the nebulizer system named on the product label (the Ventavis label specifies the I-neb AAD System and warns that other systems may not give the right dose). Each treatment takes about 5-15 minutes. The frequent dosing schedule is the main inconvenience. Typically used as add-on therapy to oral PAH medications.
▸Is Iloprost FDA approved?
Yes, Iloprost (Ventavis) is FDA approved (2004) for the treatment of Pulmonary Arterial Hypertension.
▸How many times a day does iloprost need to be inhaled?
Iloprost is inhaled 6-9 times daily while awake, with each treatment session lasting 5-15 minutes using a specialized nebulizer. This frequent dosing schedule is the main practical limitation. Treatments are typically spaced throughout the day to maintain consistent pulmonary vasodilation. The frequency can be burdensome, and adherence to the schedule is important for optimal benefit.
▸How does inhaled iloprost compare to inhaled treprostinil?
Both are inhaled prostacyclins for PAH, but they differ in dosing frequency and device. Iloprost requires 6-9 inhalations daily using a jet nebulizer, while inhaled treprostinil (Tyvaso) requires 4 treatments daily and is available as both a nebulizer and dry-powder inhaler (Tyvaso DPI). The fewer daily treatments and device options make treprostinil more convenient for many patients. However, iloprost may be preferred in some clinical situations or insurance formularies.
▸Can iloprost be used with other PAH medications?
Yes. Iloprost is commonly used as add-on therapy to oral PAH medications including endothelin receptor antagonists (bosentan, macitentan, ambrisentan) and PDE5 inhibitors (sildenafil, tadalafil). Combination therapy is the standard of care in PAH, and inhaled prostacyclins are often the second or third drug added to an oral regimen when additional treatment is needed.
▸Does iloprost cause coughing?
Cough is the most common side effect of inhaled iloprost, affecting a significant proportion of patients. The cough is typically transient, occurring during or shortly after inhalation, and tends to improve over time. Using proper inhalation technique and ensuring the nebulizer is functioning correctly can help minimize coughing. If cough is persistent or severe, your physician may consider adjusting the dose or switching to a different prostacyclin formulation.