Consideration on prevention of phlebitis and venous pain from intravenous prostaglandin E1 administration by adjusting solution pH: In vitro manipulations affecting pH

Abstract

Prostaglandin E1 (PGE1; Alprostadil Alfadex) is a potent vasodilator and inhibitor of platelet aggregation used to treat patients with peripheral vascular disease. The main adverse effects of intravenous PGE1 administration, phlebitis and venous pain, arise from the unphysiologically low pH of infusion solutions. When PGE1 infusion solutions with a pH value greater then 6 are used, phlebitis and venous pain are considered to be avoidable. Beginning with a PGE1 infusion solution with pH greater than 6, we add the amount of 7% sodium bicarbonate needed to bring the solution to pH 7.4 if phlebitis or venous pain develops. In the present study we established a convenient nomogram showing the relationship between the titratable acidity of various infusion solutions and the volume of 7% sodium bicarbonate required to attain pH 7.4 for preventing the phlebitis and venous pain associated with PGE1 infusion. © 2008 The Pharmaceutical Society of Japan.