Orenitram (Treprostinil) Dosages: Your GoodRx Guide

If you have pulmonary arterial hypertension (PAH), your healthcare team may discuss several different treatment options. Orenitram (treprostinil) is an oral medication they may consider, especially if you have difficulty with infused or inhaled PAH medications.

When you’re prescribed Orenitram, you’ll receive specific dosage instructions. Expect to start with a low dose that’s slowly increased over time. Here’s what you should know about typical Orenitram dosages.

What’s the typical Orenitram dosage?

Orenitram is available as an oral tablet in five different doses:

• 0.125 mg

• 0.25 mg

• 1 mg

• 2.5 mg

• 5 mg

The typical Orenitram dosage depends on how often you’ve been instructed to take the medication. Some people are told to take Orenitram twice a day, while others take it three times daily. You’ll typically start with a low dose that increases over time, as follows:

• Twice daily dosage: 0.25 mg by mouth twice daily (taken about 12 hours apart) for at least 3 to 4 days. After that, your dose may be raised in increments of 0.25 mg or 0.5 mg taken twice daily.

• Three times daily dosage: 0.125 mg by mouth three times daily (taken about 8 hours apart) for at least 3 to 4 days. After that, your dose may be raised in increments of 0.125 mg taken three times daily.

Your Orenitram dosage is typically increased to the highest dosage that you can tolerate, up to 120 mg total per day. This means you could take as many as 24 of the 5 mg tablets (the highest tablet dosage) over the course of a day. Your prescriber will determine how and when to increase your Orenitram dosage. Do not change it without their instruction.

Regardless of your Orenitram dosage, take your dose with food to make sure your body properly absorbs it. Swallow the tablets whole. Do not crush, chew, or split them.

Some people may start on the infused version of treprostinil, Remodulin. When switching from Remodulin to Orenitram, your prescriber will have you slowly reduce your Remodulin dose while increasing your Orenitram dose. Be sure to follow their instructions.

Good to know: Do not abruptly stop taking Orenitram. This can worsen your PAH symptoms. If you need to stop taking Orenitram, talk to your prescriber first. They will help you slowly reduce your dose over time to avoid problematic PAH symptoms.

EXPERT PICKS: WHAT TO READ NEXT

• How they compare: Many medications can help manage pulmonary arterial hypertension (PAH). Learn about the different types of PAH medications and how they compare.

• Guide to pulmonary arterial hypertension: Experts break down the different symptoms, causes, and treatments of PAH.

• Portable oxygen therapy: Some people living with PAH may be prescribed oxygen therapy to help with symptoms such as shortness of breath. Learn more about portable oxygen options that allow you to use oxygen outside the home.

Are there any dosage adjustments for health conditions or medication interactions?

Your prescriber will consider your full health history and the other medications you’re taking when deciding on your Orenitram dosage. Make sure that they have up-to-date and accurate information. 

Health conditions

If you have mild liver impairment, the recommended Orenitram starting dosage is 0.125 mg twice daily. The dose is then raised in increments of 0.125 mg taken twice daily. But Orenitram isn’t recommended if you have moderate or severe liver impairment. Your prescriber can help determine your liver health and whether Orenitram is right for you.

Interactions

Orenitram can significantly interact with other medications. This is because it’s broken down by specific proteins (enzymes) in your liver. 

If you take other medications that prevent these proteins from working properly, you could be exposed to higher Orenitram levels. And that can increase your risk of side effects. If you need to take an interacting medication, such as gemfibrozil (Lopid), your prescriber will likely lower your Orenitram dose.

Other interactions are possible. Share your current medication list with your healthcare team to check for potential interactions ahead of time.

What happens if you miss a dose of Orenitram?

If you miss a dose of Orenitram, take it as soon as possible. But if you miss two or more doses, it’s recommended to restart at a lower dose and work your way up to your usual dose again. In this scenario, contact your prescriber for specific dosage instructions.

Remembering to take your medication isn’t always easy. But there are several tools to help you. For example, you could try using a medication reminder app on your smartphone.

What should you do if you take too much Orenitram?

Taking too much Orenitram may increase your risk of side effects such as severe headache, nausea and vomiting, and diarrhea. Low blood pressure (hypotension) is also possible.

If you think you may have taken too much Orenitram, contact your healthcare team right away. You can also call Poison Control for assistance at 1-800-222-1222.

Why trust our experts?

Written by:

Brian Leonard, PharmD, BCACP, BCGP

Brian Leonard earned his doctorate in pharmacy from the University of Florida College of Pharmacy and is board certified in Ambulatory Care and Geriatric Pharmacy.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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