Treprostinil belongs to the class of medications called vasodilators. Vasodilators open up (dilate) the blood vessels in your body by relaxing the muscles in the walls of the blood vessels. This helps to lower your blood pressure and allows blood to flow more easily around your body, leading to improved heart function and your ability to exercise.

Treprostinil is used for the long-term treatment of pulmonary hypertension. People with pulmonary hypertension have high blood pressure in the blood vessels of the lungs. The high pressure makes it difficult for blood to travel to the lungs and pick up oxygen. This makes the heart work harder in order to push enough blood into the lungs, and over time can lead to heart problems.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The recommended dose of treprostinil will vary on an individual basis. This medication is given either under the skin (subcutaneously) or into the vein (intravenously). It is given as a continuous infusion, which means that the medication will be flowing into your body on a constant basis. A health care provider will decide which route is best for you to receive the medication.

If you are being given treprostinil intravenously, you will need to have a special device inserted into your vein for the medication to be given (called a central venous catheter).

If you are being given treprostinil subcutaneously, you will need to have a self-inserted catheter (tube) placed under your skin. Both of these methods will require the use of a special pump that will help deliver the medication into your vein. A health care professional will teach you (and your caregiver or family member) how to prepare the medication and how to use the pump.

Your doctor will monitor your response to the medication and may adjust the dose of based on how you respond. A health care provider will teach you how to change your dose when and if it is necessary.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as recommended by your doctor. If your infusion of treprostinil is interrupted for any reason, contact your doctor to discuss what you should do.

Undiluted (unmixed) treprostinil that has been transferred into a syringe can be used for up to 72 hours. Treprostinil that has been mixed with other solutions (such as normal saline or sterile water for injection) can be used for up to 48 hours after it has been mixed.

A single vial of treprostinil should not be used for more than 30 days after the first time you punctured the vial. If you notice that the vial of treprostinil contains a liquid that is hazy, contains particles, or has leaks, you should not use that vial and discard it.

Store this medication at room temperature (between 15°C to 30°C) and keep it out of the reach of children.

1 mg/mL
Each mL of Remodulin Injection, 1 mg/mL, contains 1 mg of treprostinil (as treprostinil sodium). Nonmedicinal ingredients: sodium citrate, sodium chloride, metacresol, sodium hydroxide, and water for injection. Hydrochloric acid and sodium hydroxide may have been added to adjust pH.

2.5 mg/mL
Each mL of Remodulin Injection, 2.5 mg/mL, contains 2.5 mg of treprostinil (as treprostinil sodium). Nonmedicinal ingredients: sodium citrate, sodium chloride, metacresol, sodium hydroxide, and water for injection. Hydrochloric acid and sodium hydroxide may have been added to adjust pH.

5 mg/mL
Each mL of Remodulin Injection, 5 mg/mL, contains 5 mg of treprostinil (as treprostinil sodium). Nonmedicinal ingredients: sodium citrate, sodium chloride, metacresol, sodium hydroxide, and water for injection. Hydrochloric acid and sodium hydroxide may have been added to adjust pH.

10 mg/mL
Each mL of Remodulin Injection, 10 mg/mL, contains 10 mg of treprostinil (as treprostinil sodium). Nonmedicinal ingredients: sodium citrate, sodium chloride, metacresol, sodium hydroxide, and water for injection. Hydrochloric acid and sodium hydroxide may have been added to adjust pH.

Do not use this medication if you are allergic to treprostinil, any medications with a similar chemical structure to the medication, or any ingredients of the medication.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• diarrhea
• dizziness
• fluid retention
• flushing
• headache
• hypotension (low blood pressure)
• jaw pain
• loss of appetite
• nausea
• pain at the site of infusion
• rash
• redness or rash at the site of infusion

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• bruising
• fainting
• numbness
• swelling
• symptoms of an intravenous line infection (e.g., redness, tenderness, swelling, or pus at the infusion site)

Seek immediate medical attention if any of the following occur:

• sudden onset of fever
• symptoms of a blood infection (e.g., fever, headache, fatigue)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Infection: Since this medication is given intravenously and usually for a long period of time through a central venous catheter, this increases your risk of infections in the blood, which can be fatal.

If you notice any signs or symptoms such as a sudden onset of fever, fatigue, or headache, contact your doctor immediately. Giving the medication intravenously also puts you at increased risk of infections at the infusion site. Contact your doctor as soon as possible if you notice symptoms such as redness, tenderness, swelling, or pus at the infusion site.

Kidney or liver disease: If you have kidney or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stopping the medication: Stopping treprostinil abruptly or sudden large decreases in the dose can result in symptoms of pulmonary hypertension such as pain when breathing (dyspnea), dizziness, weakness, and fatigue. If your treprostinil is stopped abruptly for some reason and you develop these symptoms, contact your doctor immediately.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if treprostinil passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 16 years of age.

Seniors: The safety and effectiveness of using this medication have not been established for people above 65 years of age.

There may be an interaction between treprostinil and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• alfuzosin
• alpha agonists (e.g., clonidine, methyldopa)
• angiotensin converting enzyme inhibitors (ACEIs; captopril, ramipril)
• angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
• antiarrhythmics (e.g., amiodarone, dipyridamole, disopyramide, flecainide, procainamide, quinidine)
• anti-psychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• apixaban
• beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• celecoxib
• chloroquine
• dabigatran
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
• domperidone
• edoxaban
• gemfibrozil
• heparin
• herbal products that affect blood clotting (e.g., cat's claw, chamomile, fenugreek, evening primrose, feverfew, garlic, ginger, ginseng, turmeric)
• hydralazine
• low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• methadone
• mifepristone
• nitrates (e.g., isosorbide dinitrate, nitroglycerin)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)
• phenytoin
• prasugrel
• primidone
• protein kinase inhibitors (e.g., lapatinib, pazopanib, sunitinib)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, ofloxacin,
• ritonavir
• saquinavir
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
• serotonin-norepinephrine reuptake inhibitors (SNRIs; desvenlafaxine, duloxetine, venlafaxine)
• tetrabenazine
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.