the use of prostaglandians in maintaining the patency of the arterial duct in congenital heart disease is well established. Intravenous1-3 and ora12–4 administration has been used, although for acute use intravenous and possibly intraosseous5 routes are favored. Both prostaglandin E1 (alprostadil—ProstinVR: Upjohn)1,4 and prostaglandin E2 (dinoprostone—Prostin E2: Upjohn)2,3 are used for this purpose, although only prostaglandin E1 is licensed for this indication in the United Kingdom. Prostaglandin E1 costs approximately 8 times more than prostaglandin E2 (£56.96 versus £7.43 per vial).