Patients who are being treated at home for primary pulmonary hypertension with a continuous I.V. epoprostenol infusion normally receive the drug through an ambulatory infusion pump. Some facilities have a policy for converting these patients, when they're hospitalized, to hospital infusion pumps, which may have safety features such as dose checking. Because epoprostenol is incompatible with other I.V. medications, I.V. tubing used to administer this drug shouldn't have a Y connector, which is used to administer other drugs.

Some hospitals are administering epoprostenol with Hospira Plum infusion pumps using epidural administration sets. Although an epidural administration set has no Y connector, the yellow stripe running the length of the tubing indicates it's for epidural use. Additionally, the tubing package is confusing because it's labeled "Primary I.V. Plumset," although a yellow label in the package states "epidural line only."

Confusing I.V. and epidural tubing is plumb dangerous. Tubing with a yellow stripe is intended for epidural infusions only. Hospira makes Plum administration sets with standard I.V. tubing with no Y connectors, which should be dispensed by the pharmacy with epoprostenol. The company is looking into clarifying its tubing product labeling.