Treprostinil (Inhalation)

The symptoms of pulmonary arterial hypertension are treated with Treprostinil inhalation. It works by blocking a hormone that is found in large quantities in the heart and lungs of those with pulmonary arterial hypertension.

Overview

Treprostinil is used to treat the symptoms of pulmonary arterial hypertension in patients.

Pulmonary arterial hypertension is caused by high blood pressure that occurs in the main artery that carries blood between the right side of the heart and the lungs. This condition can be caused by a wide range of factors and the effect is the thickening and stiffening of arteries, narrowing the space through which blood can pass and increasing the blood pressure.

Treprostinil works by blocking a hormone that is found in the blood and lungs of those suffering from pulmonary arterial hypertension in larger than normal quantities.

Treprostinil is inhaled and helps the patient by increasing the flow of blood to reduce the workload placed on the heart.

This medicine is available only with a doctor's prescription and dose will vary depending on both effect and tolerance.

Typically it is taken first thing in the morning, before activities and, where possible, around meal times.

Commonly reported side effects of inhalation include a cough, headache, throat irritation and diarrhea.

Condition Treated

  • Pulmonary arterial hypertension symptoms

Type of Medicine

  • Vasodilator

Side effects

Along with the required effects of medicines, it is possible that they can create unwanted side effects too. In some cases, these side effects may require further medical attention. Other side effects will not require attention.

Contact your doctor immediately if you experience any of the following side effects when taking this medicine:

More common

  • Cough
  • Fainting
  • Feeling of warmth
  • Redness of the face, neck, arms and occasionally, upper chest
  • Sore throat

Incidence not known

  • Bloody nose
  • Chest pain
  • Coughing or spitting up blood
  • Difficulty in breathing or troubled breathing
  • Fever or chills
  • Sneezing
  • Tightness in the chest

Overdosing on medication can be very dangerous. Seek immediate medical help if any of the following symptoms of overdose are experienced:

  • Blurred vision
  • Confusion
  • Diarrhea
  • Dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • Headache
  • Nausea
  • Sweating
  • Unusual tiredness or weakness
  • Vomiting

Other side effects that occur will not necessarily need medical attention. Your medical professional may, however, be able to provide you with means with which to alleviate the side effects or advice on how you can remedy them. If these side effects become bothersome or are ongoing, inform your doctor and seek advice.

  • Abdominal or stomach cramps, discomfort or pain
  • Back pain
  • Constipation
  • Indigestion
  • Loss of appetite
  • Muscle, jaw, or bone pain
  • Swollen mouth and tongue
  • Unpleasant taste
  • Urge to have bowel movement

Other side effects that are not listed herein may also occur. If you experience any other side effects, inform your doctor or medical professional and seek advice.

Dosage

Treprostinil should be taken first thing in the morning. You should also take a dose before any physical activity.

Do not take doses more frequently than once every four hours.

Do not change your dose without talking to your doctor.

Treprostinil is breathed into the lungs using an inhalation device. Carefully follow instructions for operation and cleaning of the device. Do not attempt to inhale any other substances or medications through the device.

It is always recommended that you have a backup inhalation device available so that you can ensure you do not miss any doses.

The dose prescribed will vary for different patients. Follow the directions given by your doctor and familiarize yourself with the instructions. The following information is a guideline only and you should follow the doses suggested by your doctor.

The amount of medicine taken will vary depending on the strength of the medicine and the frequency with which you take it will depend on your personal condition.

Guideline doses are as follows:

Adults - 18 micrograms or three breaths per treatment session. Take 4 times per day Dose can be adjusted but should not normally be more than 9 breaths per day.

Children - Dose to be determined by the doctor.

If you miss a dose of this medicine you should take it as soon as you are able to. If, however, it is close to your next dose then you should not take the dose and return to your usual schedule. Never take double doses.

You should visit your doctor regularly for check-ups when taking this medicine to ensure that it is working effectively. Your doctor will need to make regular blood pressure checks and you may also need to measure your blood pressure at home. If you notice any changes in blood pressure, the recommended course of action is that you contact your medical professional immediately.

It is possible when you take this medicine that you will experience a drop in blood pressure and may become lightheaded or dizzy. You will become aware of how this medicine affects you and should assess this before you drive, use any machinery or operate anything that could put you or others at risk were you to become dizzy or not alert.

When you take this medicine, stand up slowly when getting out of a chair or out of bed.

Do not take any other medicines unless you have discussed them with your doctor. This will include any over the counter medicines that you might be taking, as well as any herbal medicines. Vitamin supplements should also be discussed with your doctor when taking this medicine.

Interactions

In deciding to use this medicine, it is important to weigh the positives and negatives against one another with your doctor. Medicines can have adverse effects with other medicines that you are taking.

Certain medicines can react with one another in the body and should not be taken together. Others can be taken together, but your doctor may wish to monitor the effects closely. When taking Treprostinil, the following medicines are particularly significant. Please note that this list is not all-inclusive, it has been compiled due to the severity of interactions.

The use of the following medicines in concurrence with Treprostinil is not recommended. Your doctor may wish to change one medicine for another:

  • Defibrotide

Use of the following medicines is not usually recommended concurrently with Treprostinil. Your doctor may still wish to prescribe both:

  • Aceclofenac
  • Acemetacin
  • Alipogene Tiparvovec
  • Alteplase, Recombinant
  • Amtolmetin Guacil
  • Anagrelide
  • Apixaban
  • Ardeparin
  • Argatroban
  • Aspirin
  • Bemiparin
  • Bivalirudin
  • Bromfenac
  • Bufexamac
  • Celecoxib
  • Certoparin
  • Choline Salicylate
  • Citalopram
  • Clonixin
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desirudin
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyridamole
  • Dipyrone
  • Droxicam
  • Edoxaban
  • Enoxaparin
  • Eptifibatide
  • Escitalopram
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Fluoxetine
  • Flurbiprofen
  • Fluvoxamine
  • Fondaparinux
  • Heparin
  • Ibuprofen
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lepirudin
  • Levomilnacipran
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Morniflumate
  • Nabumetone
  • Nadroparin
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Parnaparin
  • Paroxetine
  • Phenindione
  • Phenprocoumon
  • Phenylbutazone
  • Piketoprofen
  • Piracetam
  • Piroxicam
  • Pixantrone
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Protein C
  • Reviparin
  • Rivaroxaban
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sertraline
  • Sodium Salicylate
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tinzaparin
  • Tolfenamic Acid
  • Tolmetin
  • Valdecoxib
  • Vilazodone
  • Vortioxetine
  • Warfarin

Certain medicines should not be taken with tobacco and alcohol. Consult your doctor about your tobacco and alcohol usage when receiving a prescription for this medicine.

Other medical problems can also affect the use of medicines. If you have any of the following conditions, be sure to inform your doctor before taking the medicine:

  • Asthma
  • Breathing problems
  • Bleeding problems
  • Chronic obstructive pulmonary disease (COPD)
  • Hypotension
  • Lung infection
  • Kidney disease
  • Liver disease

Lung infections may be made worse by the inhalation of Treprostinil.

Liver problems may lead to the medicine staying in the bloodstream for longer and this can increase its effect. If you have severe liver disease then you should not use this medicine.

Warnings

This medicine should not be taken during pregnancy. Animal studies have shown an adverse effect on the embryo.

There are no adequate studies to determine if there is a risk from breastfeeding while taking this medicine. You should weigh the benefits of doing so against the potential risks. Discuss this with your doctor although it is recommended that you do not breastfeed while taking this medicine.

This medicine can cause dizziness and make patients less alert. You should know how you react to this medicine before you consider driving, operating machines or carrying out actions that could put you or others at risk.

Do not overdose on this medicine. Overdosing on Treprostinil can be very serious and can lead to ongoing complications. If you suspect that you or anyone else has overdosed on Treprostinil, seek emergency medical attention immediately. Symptoms of overdose can include:

  • Blurred vision
  • Confusion
  • Diarrhea
  • Dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • Headache
  • Nausea
  • Sweating
  • Unusual tiredness or weakness
  • Vomiting

You should not use Treprostinil if you have severe liver disease or diverticulosis (an intestinal disorder). Liver disease will prevent your body from being able to remove this drug from the bloodstream, which can lead to overdosing effects as the medicine has a greater effect staying in the body for longer.

Storage

Always keep medicines out of the reach of children.

Store in a closed container at room temperature.

Keep medicine in a safe place away from heat, moisture and direct light.

Do not allow medicine to freeze.

Keep medicine in the unopened foil pouch until you are ready to use it. Once the pack is opened use contents within 7 days.

Do not keep out of date medicine. Ask your doctor how you should dispose of it.

Summary

Treprostinil is used for the treatment of symptoms of pulmonary arterial hypertension.

Pulmonary arterial hypertension is a condition where the arteries thicken and stiffen making it difficult for blood to reach the lungs. In particular it refers to the contraction of the main artery leading from the heart's right ventricle to the lungs.

Treprostinil works by inhibiting a particular naturally created hormone that is found in abundant quantities in those suffering from pulmonary arterial hypertension. The effect is the relaxing of the arteries allowing for easier blood flow between heart and lungs. This lowers blood pressure and improves function.

The medicine is taken by inhalation using a custom inhalation device. The medicine should be taken first thing in the morning and then every 4 hours throughout the day or as instructed by your doctor. Treprostinil can also be taken before physical activity.

It is always recommended that you have a back up inhalation device available so that you do not miss doses should you misplace it. If you miss a dose you should never take a double dose.

This medicine can interact with a wide range of other medication, so it is important that you inform your doctor of any medication that you are taking. Use can also be affected by other medial conditions that you may have. If you have any existing medical conditions then you should inform your doctor before taking this medicine. This is particularly important in cases of heart, liver or kidney function.

This medicine should be used with extreme caution if you have any kind of lung infection. The inhalation of Treprostinil can worsen infections of the lungs.

Medicine should be kept in the sealed foil package until needed. Once the foil is broken the medicine should be used within 7 days.

This medicine should not be taken during pregnancy.

This medicine can cause dizziness and make patients less alert. You should know how you react to this medicine before you consider driving, operating machines or carrying out actions that could put you or others at risk.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
April 03, 2018
Content Source: