Iloprost

Summary

Iloprost (CHEMBL494) is an approved small-molecule platelet aggregation inhibitor (ATC B01AC11) targeting PTGDR, PTGER1, and PTGER2; indicated across 16 conditions including pulmonary arterial hypertension and thrombotic disease.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: B01AC11
• Targets: 8 (PTGDR, PTGER1, PTGER2…)
• Indications: 16 conditions
• Clinical trials: 57
• Chemistry: 360.5 Da · C22H32O4

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL494
Name	Iloprost
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	5311181
ChEBI	CHEBI:63916
ATC	B01AC11
Molecular formula	C22H32O4
Molecular weight	360.5
InChIKey	HIFJCPQKFCZDDL-ACWOEMLNSA-N

SMILES: CC#CCC(C)[C@@H](/C=C/[C@H]1[C@@H](C[C@H]2[C@@H]1C/C(=C/CCCC(=O)O)/C2)O)O

IUPAC name: (5E)-5-[(3aS,4R,5R,6aS)-5-hydroxy-4-[(E,3S)-3-hydroxy-4-methyloct-1-en-6-ynyl]-3,3a,4,5,6,6a-hexahydro-1H-pentalen-2-ylidene]pentanoic acid

ChEBI definition: A carbobicyclic compound that is prostaglandin I2 in which the endocyclic oxygen is replaced by a methylene group and in which the (1E,3S)-3-hydroxyoct-1-en-1-yl side chain is replaced by a (3R)-3-hydroxy-4-methyloct-1-en-6-yn-1-yl group. A synthetic analogue of prostacyclin, it is used as the trometamol salt (generally by intravenous infusion) for the treatment of peripheral vascular disease and pulmonary hypertension.

Pharmacological roles (ChEBI): platelet aggregation inhibitor, vasodilator agent.

Also known as: Aurlumyn, Ciloprost, Endoprost, Ilomedin, Iloprost, Ventavis, ZK 00036374, ZK-00036374, ZK-36374, ILOPROST, iloprost, SID144207135

Parent form; salt/anhydrous children: CHEMBL5315118

Patent coverage: 105 distinct patent families (234 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

Gene	Target	Action	pAffinity	Cancer dependency	UniProt
PTGDR	DP1 receptor	Full agonist	6.6	0.4%	Q13258
PTGER1	EP1 receptor	Full agonist	8	0.4%	P34995
PTGER2	EP2 receptor	Full agonist	5.7	0.1%	P43116
PTGER3	EP3 receptor	Full agonist	6.68	2.6%	P43115
PTGER4	EP4 receptor	Full agonist	6.4	0.5%	P35408
PTGFR	FP receptor	Full agonist	6.2	0%	P43088
PTGIR	IP receptor	Full agonist	8	0.2%	P43119
TBXA2R	TP receptor	Full agonist	5.2	0.2%	P21731

Broader ChEMBL bioactivity targets: 6 (assay-derived). Sample: Prostaglandin E2 receptor EP1 subtype, Prostaglandin E2 receptor EP2 subtype, Prostacyclin receptor, Prostacyclin receptor, Prostaglandin E2 receptor EP3 subtype, Prostaglandin D2 receptor.

Bioactivity

ChEMBL activities: 22 potent at pChembl ≥ 5 of 22 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
PTGER1	9.52	EC50	0.3	nM	CHEMBL_ACT_24775875
PTGIR	9.4	EC50	0.4	nM	CHEMBL_ACT_24775871
P43253	9.16	EC50	0.69	nM	CHEMBL_ACT_18017589
P43253	9	Ki	1	nM	CHEMBL_ACT_18017729
PTGIR	8.62	EC50	2.4	nM	CHEMBL_ACT_18017544
PTGIR	8.49	Ki	3.2	nM	CHEMBL_ACT_18017711
PTGIR	8.32	Ki	4.8	nM	CHEMBL_ACT_13342004
PTGIR	8.19	Ki	6.5	nM	CHEMBL_ACT_1487960
PTGIR	8.19	Ki	6.5	nM	CHEMBL_ACT_247781
PTGIR	8.14	Ki	7.3	nM	CHEMBL_ACT_2381331
PTGIR	8.08	IC50	8.4	nM	CHEMBL_ACT_13342076
PTGIR	8.05	IC50	9	nM	CHEMBL_ACT_18017609
PTGIR	8	IC50	10	nM	CHEMBL_ACT_16501800
PTGIR	8	IC50	10	nM	CHEMBL_ACT_16838448
PTGIR	7.89	IC50	13	nM	CHEMBL_ACT_13336174
PTGIR	7.77	IC50	17	nM	CHEMBL_ACT_2401834
PTGIR	7.57	IC50	27	nM	CHEMBL_ACT_1110469
PTGIR	7.57	IC50	27	nM	CHEMBL_ACT_776738
PTGDR	6.83	EC50	147	nM	CHEMBL_ACT_18017480
PTGDR	5.69	EC50	2059	nM	CHEMBL_ACT_24775869
PTGER2	5.68	EC50	2094	nM	CHEMBL_ACT_24775873
PTGER3	5.43	Ki	3700	nM	CHEMBL_ACT_18017723

Target pathways

Aggregated over 8 target gene(s): PTGDR, PTGER1, PTGER2, PTGER3, PTGER4, PTGFR, PTGIR, TBXA2R.

Top Reactome pathways

16 total, by targets touching each:

Pathway	Targets	Genes
Prostanoid ligand receptors	8	PTGDR, PTGER1, PTGER2, PTGER3, PTGER4, PTGFR, PTGIR, TBXA2R
G alpha (s) signalling events	4	PTGDR, PTGER2, PTGER4, PTGIR
G alpha (q) signalling events	3	PTGER1, PTGFR, TBXA2R
Hemostasis	1	TBXA2R
Signal Transduction	1	TBXA2R
Signaling by GPCR	1	TBXA2R
Class A/1 (Rhodopsin-like receptors)	1	TBXA2R
GPCR downstream signalling	1	TBXA2R
Eicosanoid ligand-binding receptors	1	TBXA2R
Signal amplification	1	TBXA2R
Prostacyclin signalling through prostacyclin receptor	1	PTGIR
G alpha (12/13) signalling events	1	TBXA2R
G alpha (i) signalling events	1	PTGER3
Thromboxane signalling through TP receptor	1	TBXA2R
GPCR ligand binding	1	TBXA2R
Platelet activation, signaling and aggregation	1	TBXA2R

Dominant GO biological processes

GO term	Targets
inflammatory response	8
G protein-coupled receptor signaling pathway	8
positive regulation of cytosolic calcium ion concentration	8
signal transduction	8
adenylate cyclase-activating G protein-coupled receptor signaling pathway	7
response to lipopolysaccharide	5
cellular response to prostaglandin D stimulus	2
phospholipase C-activating G protein-coupled receptor signaling pathway	2
response to prostaglandin E	2
cellular response to prostaglandin E stimulus	2
response to lipid	2
male sex determination	1
sleep	1
mast cell degranulation	1
adenosine metabolic process	1

Indications & clinical

Indications

16 indications (3 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
pulmonary arterial hypertension	4	MONDO:0015924	EFO:0001361
thrombotic disease	4	MONDO:0000831	HP:0004419
pulmonary hypertension	4	MONDO:0005149	MONDO:0005149
toxic shock syndrome	3	MONDO:0001881	EFO:0006834
Raynaud disease	3	MONDO:0008364	EFO:1001145
adult acute respiratory distress syndrome	3	MONDO:0100130	MONDO:0100130
chronic obstructive pulmonary disease	2	MONDO:0005002	EFO:0000341
systemic sclerosis	2	MONDO:0005100	EFO:0000717
chronic kidney disease	2	MONDO:0005300	EFO:0003884
cardiac arrest	2	MONDO:0000745	EFO:0009492
multiple organ dysfunction syndrome	2	MONDO:0043726	EFO:1001373
lung neoplasm	2	MONDO:0021117	MONDO:0008903
lung carcinoma	2	MONDO:0005138	EFO:0001071
myocardial infarction	1	MONDO:0005068	EFO:0000612
humerus fracture	1	MONDO:0005319	EFO:0003943
asthma	0	MONDO:0004979	MONDO:0004979

Clinical trials

Total trials: 57.

Phase distribution

Phase	Trials
PHASE2	15
Not specified	14
PHASE3	9
PHASE4	8
PHASE1	4
PHASE2/PHASE3	3
PHASE1/PHASE2	3
EARLY_PHASE1	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT00120380	PHASE4	TERMINATED	Combination Therapy of Bosentan and Aerosolized Iloprost in Idiopathic Pulmonary Arterial Hypertension (IPAH)
NCT00403650	PHASE4	COMPLETED	Inhaled Iloprost for Sarcoidosis-associated Pulmonary Hypertension
NCT00409526	PHASE4	TERMINATED	Inhaled Iloprost for the Treatment of Persistent Pulmonary Hypertension in the Term and Near Term Infants.
NCT01116063	PHASE4	UNKNOWN	Inhaled Iloprost for Disproportionate Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease (COPD)
NCT01718288	PHASE4	COMPLETED	Optimization of Treatment in Patients With Severe Peripheral Ischemia (Fontaine Stage IIb)
NCT02170519	PHASE4	TERMINATED	Inhaled Aerosolized Prostacyclin for Pulmonary Hypertension Requiring Inhaled Nitric Oxide
NCT03044314	PHASE4	TERMINATED	Outpatient Vasodilator Assessment Using Iloprost in Pulmonary Hypertension
NCT03620526	PHASE4	UNKNOWN	Inhaled Iloprost and Exercise Hemodynamics and Ventricular Performance in Heart Failure With Preserved Ejection Fraction
NCT07498309	PHASE3	NOT_YET_RECRUITING	Evaluation of the Efficacy of Iloprost in the Management of Vaso-occlusive Crises in Adult Patients With Sickle Cell Disease
NCT00004786	PHASE3	COMPLETED	Phase III Randomized, Double-Blind, Placebo-Controlled Study of Oral Iloprost for Raynaud’s Phenomenon Secondary to Systemic Sclerosis
NCT00345501	PHASE2/PHASE3	COMPLETED	Iloprost for Prevention of Contrast-Mediated Nephropathy in High-Risk Patients Undergoing Coronary Angiography and/or Intervention
NCT00439543	PHASE2/PHASE3	UNKNOWN	Trial of Iloprost in Pulmonary Hypertension Secondary to Pulmonary Fibrosis
NCT00709098	PHASE3	COMPLETED	Safety Study Extension of Iloprost Power 15 in Pulmonary Arterial Hypertension
NCT00709956	PHASE3	COMPLETED	Iloprost Power 15 in Pulmonary Arterial Hypertension
NCT00723554	PHASE3	TERMINATED	Iloprost Power Disc-15 in Pulmonary Arterial Hypertension
NCT00927654	PHASE3	COMPLETED	Iloprost in High Risk Cardiac Surgical Patients
NCT01712997	PHASE3	UNKNOWN	Study of the Initial Combination of Bosentan With Iloprost in the Treatment of Pulmonary Hypertension Patients
NCT03111212	PHASE3	COMPLETED	Iloprost in Acute Respiratory Distress Syndrome
NCT03788837	PHASE3	COMPLETED	ILOPROST in Septic Shock With Persistent Microperfusion Defects (I-MICRO)
NCT04123444	PHASE2/PHASE3	COMPLETED	Infusion of Prostacyclin (Iloprost) vs Placebo for 72-hours in Patients With Septic Shock Suffering From Organ Failure
NCT06319274	PHASE2	RECRUITING	Infusion of Prostacyclin vs Placebo for 72-hours in Mechanically Ventilated Patients With Acute Respiratory Failure
NCT00084409	PHASE2	COMPLETED	Iloprost in Preventing Lung Cancer in Patients at High Risk for This Disease
NCT00467896	PHASE2	TERMINATED	The Power 15 Study: Safety Study of Inhalation of Ventavis With the Power Disc-15 Setting
NCT00622687	PHASE2	TERMINATED	Effect of Different Iloprost Doses on Symptoms in Systemic Sclerosis
NCT00981591	PHASE1/PHASE2	WITHDRAWN	Inhaled Iloprost as an Adjunct to Inhaled Nitric Oxide in Pediatric Critical Care Patients
NCT01082484	PHASE1/PHASE2	COMPLETED	Cutaneous Iontophoresis of Iloprost and Treprostinil in Healthy Volunteers
NCT01179776	PHASE1/PHASE2	COMPLETED	Ilomedin Treatment for Patients Having Undergone Primary Percutaneous Coronary Intervention (PCI)
NCT01437878	PHASE2	TERMINATED	Effects of Ventavis in Patients With Pulmonary Hypertension (PH) Secondary to Chronic Obstructive Pulmonary Disease (COPD)
NCT01532544	PHASE2	TERMINATED	Integrilin and Ilomedin in Combination in Comparison to Standard Treatment in Severe Pneumonia Patients With Severe Sepsis
NCT01774058	PHASE2	UNKNOWN	The Arterial Measurement of the Blood Flow Volume After Iloprost Stimulation
NCT02204852	PHASE2	COMPLETED	Co-administration of Iloprost and Eptifibatide in Septic Shock Patients
NCT02238535	PHASE2	UNKNOWN	Use of Ventavis in Patients With Postembolic Residual Pulmonary Hypertension
NCT02482402	PHASE2	WITHDRAWN	Iloprost for Bridging to Heart Transplantation in PH
NCT02685618	PHASE2	COMPLETED	Endothelial Dysfunction in Resuscitated Cardiac Arrest
NCT03903939	PHASE2	COMPLETED	Infusion of Prostacyclin vs Placebo for 72-hours in Trauma Patients With Haemorrhagic Shock Suffering From Organ Failure
NCT04420741	PHASE2	COMPLETED	Infusion of Prostacyclin (Iloprost) vs Placebo for 72-hours in COVID-19 Patients With Respiratory Failure
NCT04445246	PHASE2	COMPLETED	Inhaled Iloprost for Suspected COVID-19 Respiratory Failure
NCT05411107	PHASE2	WITHDRAWN	Oral Iloprost for the Prevention of Lung Cancer In Former Smokers
NCT00708565	PHASE1	UNKNOWN	Effects of Iloprost on Hypoxic Pulmonary Vasoconstriction and Exercise Capacity at High Altitude
NCT00724321	PHASE1	WITHDRAWN	Effects of Iloprost on Hypoxic Pulmonary Vasoconstriction at Altitude

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No PharmGKB pharmacogenomic data curated for this drug.

Related molecules

Related molecules

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

312 molecules share ≥1 primary target. Top 60 by shared-target count:

Molecule	Source	Status	Shared targets
DINOPROST	ChEMBL + PubChem	Phase 4 (approved)	PTGDR, PTGER1, PTGER2, PTGER3, PTGER4, PTGFR, PTGIR, TBXA2R
dinoprostone	ChEMBL + PubChem	Phase 4 (approved)	PTGDR, PTGER1, PTGER2, PTGER3, PTGER4, PTGFR, PTGIR, TBXA2R
LAROPIPRANT	ChEMBL	Phase 4 (approved)	PTGDR, PTGER1, PTGER2, PTGER3, PTGFR, PTGIR, TBXA2R
Grapiprant	ChEMBL + PubChem	Phase 2 (approved)	PTGER1, PTGER2, PTGER3, PTGER4, PTGFR, PTGIR, TBXA2R
RALINEPAG	ChEMBL	Phase 3	PTGDR, PTGER1, PTGER2, PTGER3, PTGER4, PTGIR
Cloprostenol	ChEMBL + PubChem	Phase 2 (approved)	PTGDR, PTGER1, PTGER2, PTGER3, PTGFR, TBXA2R
Belzutifan	PubChem	Approved	PTGDR, PTGER2, PTGER3, PTGFR, PTGIR, TBXA2R
omidenepag isopropyl	ChEMBL + PubChem	Phase 4 (approved)	PTGER1, PTGER2, PTGER3, PTGER4
TREPROSTINIL	ChEMBL + PubChem	Phase 4 (approved)	PTGDR, PTGER1, PTGER2, PTGIR
Omidenepag	ChEMBL + PubChem	Phase 2 (approved)	PTGER1, PTGER2, PTGER3, PTGER4
Alprostadil	ChEMBL + PubChem	Phase 4 (approved)	PTGDR, PTGER2, PTGIR
SELEXIPAG	ChEMBL	Phase 4 (approved)	PTGDR, PTGIR, TBXA2R
LASELIPAG	ChEMBL	Phase 2	PTGDR, PTGIR, TBXA2R
Indomethacin	ChEMBL + PubChem	Phase 4 (approved)	PTGIR, TBXA2R
Tafluprost	ChEMBL + PubChem	Phase 4 (approved)	PTGFR, TBXA2R
RAMATROBAN	ChEMBL	Phase 4 (approved)	PTGDR, TBXA2R
SEPETAPROST	ChEMBL	Phase 3	PTGER3, PTGFR
SETIPIPRANT	ChEMBL	Phase 3	PTGDR, PTGER2
TIMAPIPRANT	ChEMBL	Phase 3	PTGDR, PTGIR
BI-671800	ChEMBL	Phase 2	PTGDR, TBXA2R
BUTAPROST	ChEMBL	Phase 2	PTGER2, PTGIR
FLUPROSTENOL	ChEMBL	Phase 2	PTGER3, PTGFR
PALUPIPRANT	ChEMBL	Phase 2	PTGER2, PTGER4
Latanoprostene Bunod	PubChem	Approved	PTGFR, TBXA2R
CLOZAPINE	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
DESLORATADINE	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
DIHYDROERGOTAMINE	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
ESTRADIOL VALERATE	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
GENTIAN VIOLET	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
OLANZAPINE	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
PIMAVANSERIN	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
POMALIDOMIDE	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
REGORAFENIB	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
RIFAMPIN	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
TEGASEROD	ChEMBL + PubChem	Phase 4 (approved)	TBXA2R
ACETYLCHOLINE	ChEMBL	Phase 4 (approved)	TBXA2R
AMITRIPTYLINE	ChEMBL	Phase 4 (approved)	TBXA2R
AMLODIPINE	ChEMBL	Phase 4 (approved)	TBXA2R
AMSACRINE	ChEMBL	Phase 4 (approved)	TBXA2R
ARIPIPRAZOLE	ChEMBL	Phase 4 (approved)	TBXA2R
ASTEMIZOLE	ChEMBL	Phase 4 (approved)	TBXA2R
AXITINIB	ChEMBL	Phase 4 (approved)	TBXA2R
BECLOMETHASONE DIPROPIONATE	ChEMBL	Phase 4 (approved)	TBXA2R
BENZBROMARONE	ChEMBL	Phase 4 (approved)	TBXA2R
BENZIODARONE	ChEMBL	Phase 4 (approved)	TBXA2R
BEXAROTENE	ChEMBL	Phase 4 (approved)	TBXA2R
BITHIONOL	ChEMBL	Phase 4 (approved)	TBXA2R
BROMOCRIPTINE	ChEMBL	Phase 4 (approved)	TBXA2R
BROMODIPHENHYDRAMINE	ChEMBL	Phase 4 (approved)	TBXA2R
CABOZANTINIB	ChEMBL	Phase 4 (approved)	TBXA2R
CANDESARTAN CILEXETIL	ChEMBL	Phase 4 (approved)	TBXA2R
CANNABIDIOL	ChEMBL	Phase 4 (approved)	TBXA2R
CERIVASTATIN	ChEMBL	Phase 4 (approved)	TBXA2R
CHLORMADINONE	ChEMBL	Phase 4 (approved)	TBXA2R
CHLORPROTHIXENE	ChEMBL	Phase 4 (approved)	TBXA2R
CHOLECALCIFEROL	ChEMBL	Phase 4 (approved)	TBXA2R
CICLOPIROX	ChEMBL	Phase 4 (approved)	TBXA2R
CISAPRIDE	ChEMBL	Phase 4 (approved)	TBXA2R
CLOMIPRAMINE	ChEMBL	Phase 4 (approved)	TBXA2R
CLOTRIMAZOLE	ChEMBL	Phase 4 (approved)	TBXA2R