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treprostinil

Generic Remodulin
Used for Pulmonary Hypertension
Used for Pulmonary Hypertension

Remodulin (treprostinil) belongs to the drug class known as prostacyclin analogs. It's used for treating pulmonary arterial hypertension (PAH) in adults. It's an injection that goes under your skin or into a vein that's administered using a special pump. Side effects can include pain at the injection site, headache, and diarrhea. It's available as a brand-name and generic medication.

Reviewed by:
reviewer
Dalga Surofchy, PharmD, APh
reviewer
Kristianne Hannemann, PharmD
Last reviewed on January 16, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Remodulin (treprostinil)?

What is Remodulin (treprostinil) used for?

  • Pulmonary arterial hypertension (PAH)

How Remodulin (treprostinil) works

Remodulin (treprostinil) is a prostacyclin analog, which means that it acts like prostacyclin. Prostacyclin is a natural hormone in your body that helps widen or open up the blood vessels leading to your lungs from your heart. As a result, blood can flow through these blood vessels better, which lowers the blood pressure in those vessels. This helps your body get more oxygen and your heart to work more efficiently.

Are you looking for information on Orenitram (treprostinil) tablet or Tyvaso (treprostinil) inhalation solution instead?

Drug Facts

Common BrandsRemodulin
Drug ClassProstacyclin vasodilator
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Remodulin (treprostinil)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Note: Side effects were reported by people who injected Remodulin (treprostinil) underneath the skin.
  • Pain at the injection site (85%)
  • Reactions at the injection site, like redness or irritation (83%)
  • Headache (27%)
  • Diarrhea (25%)
  • Nausea (22%)
  • Rash (14%)
  • Jaw pain (13%)
  • Dizziness or lightheadedness (11%)
  • Swelling of the hands or feet (9%)

Other Side Effects

  • Bleeding

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Accumulation of blood at the site of injection

dry, red, hot, or irritated skin

feeling faint, dizzy, or lightheaded

feeling of warmth or heat

flushing or redness of the skin, especially on the face and neck

headache

redness, hardening of the skin, or rash at the site of injection

swelling

Less common

Blurred vision

confusion

dizziness, faintness, lightheadedness when getting up suddenly from a lying or sitting position

sudden sweating

unusual tiredness or weakness

Incidence not known

Black, tarry stools

bleeding gums

blood in the urine or stools

bone pain

changes in skin color, pain, tenderness, or swelling of the foot or leg

chest pain

decreased urine output

difficult or labored breathing

dilated neck veins

extreme tiredness or weakness

irregular breathing

irregular heartbeat

itching, pain, redness, swelling, or tenderness on the skin

paleness of the skin

pinpoint red spots on the skin

tightness in the chest

troubled breathing

unusual bleeding or bruising

weight gain

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Loss of consciousness

seizure

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

headache

jaw pain

nausea

Less common

Lack or loss of strength

loss of appetite

stomach pain

vomiting

weight loss

Incidence not known

Difficulty in moving

dizziness

joint pain

muscle ache, cramp, pain, spasm, or stiffness

pain in the arms or legs swollen joints

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Remodulin (treprostinil)

thumbs-up

Pros

One of the first choices for treating certain people at risk for worsening PAH

Can help improve PAH symptoms during exercise (e.g., how far you can walk in a given amount of time, shortness of breath)

Dose adjustments can be made based on your response

thumbs-down

Cons

Doesn't cure PAH

Injected under the skin or into a vein

Can cause pain at the injection site

pharmacist-tips

Pharmacist tips for Remodulin (treprostinil)

pharmacist

  • Your provider will give you directions on how to prepare and infuse Remodulin (treprostinil). You might need to mix it with another liquid (called a diluent) before you use it for your infusion. Your healthcare provider will let you know if and how your medication needs to be mixed with a diluent.

    • Before you use Remodulin (treprostinil) for your infusion, make sure the solution doesn't have any flakes in it and that it's clear. Otherwise, don't use the medication; it could be contaminated with germs, and it won't be safe for you to use.

      • Don't lower the Remodulin (treprostinil) dose that was prescribed to you or suddenly stop taking the medication without speaking to your healthcare provider. Otherwise, your PAH symptoms might worsen and cause shortness of breath, dizziness, or unusual weakness.

        • Make sure you have a backup pump in case your infusion pump stops working.

          • Remodulin (treprostinil) can raise your risk of bleeding. Let your healthcare provider know and get medical help if you notice a cut or any bleeding that takes longer to stop or doesn't stop.

            • Throw away any Remodulin (treprostinil) vials that have been opened or stuck with a needle after 30 days.

              faqs

              Frequently asked questions about Remodulin (treprostinil)

              What happens if you stop Remodulin (treprostinil)?
              If you stop taking Remodulin (treprostinil) all of a sudden, your PAH symptoms could get worse. This is why it isn't recommended to stop taking the medication without speaking to your provider. Your provider will probably want to lower your dose slowly first and keep a close eye on your symptoms.
              How is Remodulin (treprostinil) administered?
              Remodulin (treprostinil) is administered as an injection under the skin or into a vein continuously using a special infusion pump. Your provider will teach you how to use your pump.
              How effective is Remodulin (treprostinil)?
              The effectiveness of Remodulin (treprostinil) was measured by a 6-minute walk test. People who took Remodulin (treprostinil) for 12 weeks were able to walk 10 meters farther than those who took a placebo. Remodulin (treprostinil) also improved PAH symptoms like shortness of breath and feeling tired. Another 8-week study showed that people who took Remodulin (treprostinil) for PAH could walk farther and the distance that those who didn't take the medication could walk became less by the end of the study. As you take Remodulin (treprostinil), make sure to follow up with your provider and discuss how well the medication is working for your PAH.
              What is a Remodulin (treprostinil) pump?
              A Remodulin (treprostinil) pump is a device called an infusion pump that you wear on your body. This makes it possible for you to get the medication into your bloodstream around the clock to help with your PAH symptoms. There are a few different infusion pumps that you can use with Remodulin (treprostinil). Some of them infuse the medication under your skin and others infuse it into a vein. Your provider will help you decide which pump is best for you.
              Does Remodulin (treprostinil) cause hot flashes?
              While hot flashes weren't reported as a side effect during clinical studies of Remodulin (treprostinil), they appear to be common with the inhaled version of this medication called Tyvaso (treprostinil). Flushing could be a sign that your dose of Remodulin (treprostinil) is too high), so let your provider know if you experience warmth or reddening of the skin.
              What medications can't be taken with Remodulin (treprostinil)?
              Discuss all of your medications with your healthcare provider. Studies showed that when treprostinil tablets are taken by mouth, it can interact with some medications, such as gemfibrozil (Lopid) and rifampin (Rifadin). But it isn't known whether Remodulin (treprostinil) has the same drug interactions when it's injected into the veins or under the skin. Remodulin (treprostinil) can also raise the risk of bleeding, so let your provider know if you're taking a blood thinner. Additionally, you might be at risk for very low blood pressure if you're also taking blood pressure medications.
              How do I store Remodulin (treprostinil)?
              Store unopened vials of Remodulin (treprostinil) at room temperature until the expiration date written on the vial or carton. Once it's been opened, each multi-dose vial can be stored at room temperature for 30 days. If your Remodulin (treprostinil) solution needs to be mixed with a special diluent (fluid), the mixture can be stored for up to 14 days at room temperature. And if your Remodulin (treprostinil) solution needs to be mixed with sterile water or sodium chloride, the mixture can be stored for 4 hours at room temperature or 24 hours in the refrigerator. Ask your provider how long your Remodulin (treprostinil) vial lasts since it depends on whether it's used alone or mixed and on what diluent you use to mix it with.
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              What are the risks and warnings for Remodulin (treprostinil)?

              Remodulin (treprostinil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Risk of bloodstream infections

              • Risk factors: Infusing Remodulin (treprostinil) into a vein

                Infusing Remodulin (treprostinil) into your vein for a long time can potentially put you at risk for bloodstream infections. These infections can sometimes be life-threatening. To lower your risk of infections, wash your hands before you use Remodulin (treprostinil). Make sure that the area by your catheter is clean and pain-free. It's preferred to infuse the medication underneath your skin because there's a lower risk of bloodstream infections when the medication is given this way.

                risk-warning

                Worsening of PAH symptoms if you suddenly stop the medication or lower your dose

                Your symptoms of PAH can worsen if you lower your dose or stop taking Remodulin (treprostinil) suddenly. Make sure you have a backup infusion pump in case your pump stops working during administration. Don't lower your dose or stop taking the medication without talking to your provider first. Your provider should give you instructions how to do so safely.

                risk-warning

                Higher exposure to medication if you have liver problems

                Your liver helps break down Remodulin (treprostinil) in your body. Having liver problems can affect your body's ability to clear the medication, which can lead to higher levels of Remodulin (treprostinil) in your body. This can lead to more unwanted side effects. Let your healthcare provider know if you have a history of liver problems before you start Remodulin (treprostinil). Your dose might need to be adjusted to make sure you're safe.

                risk-warning

                Low blood pressure

                • Risk factors: History of low blood pressure | Taking medications that lower blood pressure

                  Remodulin (treprostinil) can cause your blood pressure to drop because medication helps relax and widen your blood vessels. Low blood pressure can sometimes lead to symptoms like dizziness or feeling faint. Let your provider know if you feel dizzy or lightheaded while you're taking this medication.

                  dosage

                  Remodulin (treprostinil) dosage forms

                  Typical dosing for Remodulin (treprostinil)

                  The dose depends on your body weight. The typical starting dose is 1.25 nanograms (ng)/kg of weight per minute. It's injected underneath your skin or into a vein using a special pump. Your healthcare provider will prescribe the right dose for you and explain how to use the pump.

                  Your dose might differ if you have liver problems.

                  interactions

                  Interactions between Remodulin (treprostinil) and other drugs

                  Remodulin (treprostinil) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Remodulin (treprostinil). Please note that only the generic name of each medication is listed below.

                  Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                  • Defibrotide

                  Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                  alternatives

                  What are alternatives to Remodulin (treprostinil)?

                  There are a number of medications that your doctor can prescribe in place of Remodulin (treprostinil). Compare a few possible alternatives below.
                  Remodulin (treprostinil)
                  Used for:

                  • Pulmonary arterial hypertension (PAH)

                  View Prices
                  Iloprost (Ventavis)
                  Used for:

                  • Pulmonary arterial hypertension (PAH)

                  View Prices
                  Tadalafil (Adcirca)
                  Used for:

                  • Pulmonary arterial hypertension (PAH)

                  $20.89 Lowest GoodRx priceView Prices

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                  References

                  Best studies we found

                  Humbert, M., et al. (2022). 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG). European Heart Journal.

                  Kuwana, M., et al. (2023). Efficacy, safety, and pharmacokinetics of inhaled treprostinil in Japanese patients with pulmonary arterial hypertension. Pulmonary Circulation.

                  McLaughlin, V. V., et al. (2003). Efficacy and safety of treprostinil: An epoprostenol analog for primary pulmonary hypertension. Journal of Cardiovascular Pharmacology.

                  View All References (4)

                  Mitchell, J. A., et al. (2014). Role of prostacyclin in pulmonary hypertension. Global Cardiology Science & Practice.

                  Narechania, S., et al. (2019). Treatment discontinuation or interruption in pulmonary arterial hypertension. Journal of Cardiovascular Pharmacology and Therapeutics.

                  United Therapeutics Corporation. (2023). Remodulin- treprostinil injection, solution; Sterile diluent for Remodulin- water injection, solution [package insert]. DailyMed.

                  United Therapeutics Corporation. (n.d.). Offering options to help make living with a pump easier.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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