Prostacyclin-Class Treatment

What is prostacyclin?

Prostacyclin is a natural substance found in your body. Normal prostacyclin levels help maintain blood vessel health, keeping your blood vessels open and enabling normal blood flow. People with PAH may not produce enough natural prostacyclin.

Prostacyclin-class medications are used to treat 1 of the 3 treatment pathways for PAH. Although prostacyclin was the first approved therapy for PAH, many people are not familiar with it. Prostacyclin-class therapy helps to open the blood vessels in the lungs so blood can flow more easily. They have also been shown to help improve your risk status. That’s why your doctor may prescribe a prostacyclin-class medicine.

Quote: Adding another PAH medication made a difference.  I feel like more of my day belongs to me, now.

What do prostacyclin-class medications do?

Prostacyclin-class medications work in the prostacyclin pathway to impact the imbalance. They mimic some of the effects of natural prostacyclin, such as the following:

  • Widening or opening narrow blood vessels
  • Slowing down the thickening of blood vessels
  • Preventing clotting


The function of prostacyclin in the blood vessels of the lungs widening the blood vessels vs narrow blood vessels.

Prostacyclin-class medications can help widen blood vessels in the lungs.

More than 20 years of treatment and innovation

Prostacyclin-class medications were the first type of treatment to be prescribed for PAH, and they have been used in the treatment of PAH for more than 20 years.

In the past, prostacyclin-class medicine was reserved for patients in WHO Functional Class 3 or 4. Today, however, prostacyclin-class therapy is used for patients in WHO Functional Class 2 as well.

With prostacyclin-class medication now available in pill form, many patients can start taking it earlier in the course of their disease than they could have in the past.

In addition, prostacyclin-class medications can be taken with other types of PAH medications to impact the imbalance, so you may be able to add to your current treatment plan.  

Three forms of delivery 

Originally, the only way to deliver prostacyclin-class medication was through pump therapy. But thanks to medical advances, patients today have choices. There are now 3 options for taking prostacyclin-class medications, so you can choose among oral (pill), infused (pump therapy), or inhaled delivery.

Oral prostacyclin icon


Prostacyclin infusion icon


(pump therapy)

Inhaled prostacyclin icon


How can prostacyclin-class medications help me?

Through extensive research, prostacyclin-class medications have been shown to help people with PAH in several ways.


Prostacyclin-class therapies have been shown to

Improved PAH symptoms icon

Improve your PAH symptoms, like shortness of breath and fatigue

WHO functional class for PAH icon

Do more without symptoms (improve your Functional Class)

PAH progression icon

Keep your PAH from getting worse (slow disease progression)

Icon for reducing blood pressure in the lungs

Reduce pressure in the blood vessels in the lungs

PAH 6 mintue walk test stopwatch icon

Improve distance in the 6-minute walk test

BNP or nt-proBNP PAH icon

Reduce the strain on your heart (improve NT-proBNP/BNP numbers)

Side effects of prostacyclin-class therapies

Prostacyclin-class medications may cause side effects. There may be different side effects depending on how you take the medication. Your healthcare team should be familiar with these side effects, and they can help you prepare for them.

    Talk to your healthcare provider about possible side effects before you start taking prostacyclin-class therapy. Side effects of prostacyclin-class medications may include: 

    • Headache
    • Diarrhea
    • Flu-like symptoms
    • Jaw pain
    • Muscle pain
    • Flushing
    • Nausea
    Doctor discussing prostacyclin therapy with patients.

    Prostacyclin-class therapies may help improve your risk status

    Today’s PAH treatment guidelines recommend adding medications for most patients if they are not at low risk. Prostacyclin-class therapies have been shown to improve key measures of risk status, including 6-minute walk distance, Functional Class, and NT-pro-BNP/BNP levels.

    With additional symptom control, you may be able to do more in your day and have more good days. If you are interested in improving your risk status and additional symptom control, consider talking to your healthcare provider about your treatment plan.  

    Why should you consider a prostacyclin-class therapy?

    Treatment is about more than improving your risk status—it’s about improving your symptoms so you can do more in your day

    Sometimes, you might think that “feeling OK” is as good as it will be for you. But is “good enough” really good enough? You still have goals, and today there are more options to help you meet your goals.

    Treating your PAH effectively can help you make progress toward your goals today and in the future. Consider writing down some of the personal goals you’d like to achieve.

    Your PAH team is your partner in your care

    Your healthcare provider also has goals for you, which may be different from yours. It’s in your best interest to work together with your PAH team, so be sure to share your goals. Your healthcare provider can explain how their clinical goals can support your personal goals.

    Your PAH team may be able to change the dose of your current medicines or perhaps add therapies, such as a prostacyclin-class medicine. These or other steps may help you improve your risk status, do more in your day, and strive to meet your goals.

    Patients on prostacyclin therapy walking.

    Starting the conversation

    If you’re unsure how to talk about your goals or your treatment plan with your healthcare provider, download this discussion tool, which can help make the conversation easier.

    PAH Doctor Discussion Tool

    PAH Doctor Discussion Tool

    PAH knowledge is PAH power

    True or false? In the past, prostacyclin-class therapies were typically used for patients in Functional Class 3 or 4. Now, they are used earlier for patients in Functional Class 2.

    Prostacyclin-class medicines have been shown to:

    Take the next step and find out what you can do to fight PAH

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