Tryvio
Tryvio (aprocitentan) is a medication that's used to treat high blood pressure in adults who don't have enough blood pressure control with other medications. Tryvio (aprocitentan) is used along with other blood pressure medications. Tryvio (aprocitentan) belongs to a drug class called endothelin receptor antagonists. The typical dosage for Tryvio (aprocitentan) is one tablet by mouth once daily. The most common side effects are edema (swelling) and anemia.
What is Tryvio (aprocitentan)?
What is Tryvio (aprocitentan) used for?
Hypertension (high blood pressure), taken together with other blood pressure medications
How Tryvio (aprocitentan) works
Tryvio (aprocitentan) is an endothelin receptor antagonist (ERA). It blocks the action of endothelin-1, a substance in the body that narrows the blood vessels and causes high blood pressure. Blocking the action of this substance relaxes the blood vessels in the body, which lead to lower blood pressure and easier blood flow to the heart.
Drug Facts
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What are the side effects of Tryvio (aprocitentan)?
Common Side Effects
- Edema (fluid buildup in the body, swelling; 9%)
- Anemia (4%)
Serious Side Effects
- Fluid buildup in the body: shortness of breath; swelling in the legs, ankles, or feet; irregular heartbeat; chest pain; not able to exercise; tiredness; unusual weight gain
- Liver injury: loss of appetite, nausea, vomiting, stomach pain in the upper right side, dark urine, fever, yellowing of the skin or whites of the eyes
- Anemia (low red blood cell count): tiredness, shortness of breath, irregular heartbeat, dizziness, chest pain, pale skin
- Allergic reaction: rash, red skin, swelling
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Swelling of the ankles, hands, or feet, shortness of breath or trouble breathing, sudden weight gain
Pros and cons of Tryvio (aprocitentan)
Pros
Might be a good option to add to your treatment if other blood pressure medications haven't worked well enough
Taken just once daily
Can take with or without food
Cons
Must continue to take other blood pressure medications
People who can become pregnant must use birth control and take a pregnancy test every month because of risk of harm to an unborn baby
Can affect the ability to have children in males
Pharmacist tips for Tryvio (aprocitentan)
Swallow Tryvio (aprocitentan) tablets whole; don't crush, split, or chew them. Let your prescriber know if you're having trouble swallowing the tablets. You might need to be switched to a different medication.
Make sure to mark your appointments on your calendar to see your healthcare professional (HCP) or get any blood work or tests done. These tests help check your liver health, blood cell counts, and your pregnancy status. It's important to follow up with your HCP as instructed to make sure Tryvio (aprocitentan) is working well and is as safe for you as possible.
Talk with your healthcare team about whether it's safe to drink alcohol while you're taking Tryvio (aprocitentan). In general, you should try to avoid drinking alcohol if you have high blood pressure. Regularly drinking alcohol can raise your blood pressure; this can make it harder for your blood pressure medications to work well for you.
If you're able to become pregnant, be sure to use birth control during your treatment with Tryvio (aprocitentan) and for at least 1 month after your last dose. You'll also need to take a pregnancy test every month during treatment and 1 month after your last dose. It's important to avoid getting pregnant while you're taking Tryvio (aprocitentan) because the medication can harm an unborn baby. Tell your healthcare team right away if you become pregnant.
It's not recommended to breastfeed while you're taking Tryvio (aprocitentan). Discuss safer ways to feed your baby while you're taking this medication with your HCP.
Frequently asked questions about Tryvio (aprocitentan)
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What are the risks and warnings for Tryvio (aprocitentan)?
Tryvio (aprocitentan) 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.
Not safe to use during pregnancy
Tryvio (aprocitentan) shouldn't be taken during pregnancy because it can cause severe and life-threatening harm to unborn babies. Because of this risk, this medication is available only through the Tryvio REMS program. The Risk Evaluation and Mitigation Strategies (REMS) program helps make sure that the medication is as safe as possible for people who can become pregnant.
For people who can become pregnant, you'll need to take a pregnancy test before you start Tryvio (aprocitentan), monthly during treatment, and once more a month after you stop the medication. In addition, you should use birth control during treatment with Tryvio (aprocitentan) and for at least 1 month after completing treatment. Stop taking Tryvio (aprocitentan) and contact your healthcare team right away if you become pregnant.
Liver injury
Risk factors: Liver problems
Tryvio (aprocitentan) can cause elevated liver enzyme levels in the blood, which can be a sign of liver injury. It's important to keep up with your appointments and get blood work done regularly to make sure the medication stays safe for you. Get medical help right away if you develop signs of liver injury, such as nausea, vomiting, upper belly pain, dark urine, loss of appetite, fatigue, fever, or yellowing of the eyes or skin.
Fluid buildup in the body
Risk factors: Older age | Kidney problems | Heart failure
Tryvio (aprocitentan) can cause fluid buildup in the body, leading to swelling or shortness of breath. This fluid buildup can be severe and worsen heart failure if you have this heart condition. Let your prescriber know before you start Tryvio (aprocitentan) if you have any heart problems or heart failure.
Contact your healthcare professional (HCP) if you have any signs of fluid buildup in the body while you're taking Tryvio (aprocitentan). Be aware of any shortness of breath; swelling in the legs, ankles, or feet; irregular heartbeat; problems exercising; or tiredness.
Anemia (low red blood cell count)
Risk factors: Severe anemia
Tryvio (aprocitentan) might cause your hemoglobin levels to go down. Hemoglobin is the protein in your red blood cells that carries oxygen to the rest of your body. Low hemoglobin levels can lead to anemia (a low red blood cell count). Speak with your prescriber if you have a history of anemia to make sure this medication is safe for you.
You'll need regular blood tests done so your HCP can check your hemoglobin levels during treatment. In studies, a drop in hemoglobin levels happened early after people started Tryvio (aprocitentan). Levels stabilized throughout treatment, and then went back to normal after stopping the medication.
Let your HCP know if you experience symptoms of anemia, such as weakness, shortness of breath, dizziness, fast or irregular heartbeat, or pale skin, while you're taking Tryvio (aprocitentan).
Low sperm count
Tell your prescriber if you're a male, are prescribed Tryvio (aprocitentan), and you possibly might want to have children in the future. This medication might not be the best option for you because it can potentially lower your sperm count. It's not known whether this effect is reversible after you stop the medication.
Tryvio (aprocitentan) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 12.5mg | 30 tablets | $774.60 | $25.82 |
Typical dosing for Tryvio (aprocitentan)
The typical dose is 12.5 mg by mouth once daily.
How much does Tryvio (aprocitentan) cost?
Tryvio (aprocitentan) contraindications
Currently pregnant
What are alternatives to Tryvio (aprocitentan)?
Hypertension (high blood pressure), taken together with other blood pressure medications
Chest pain (angina)
Lower risk of death after heart attack
What is the latest news about Tryvio (aprocitentan)?
Tryvio (aprocitentan) images
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References
Best studies we foundAmerican Society of Hematology. (n.d.). Anemia.
Angeli, F., et al. (2021). Aprocitentan, a dual endothelin receptor antagonist under development for the treatment of resistant hypertension. Cardiology and Therapy.
Danaietash, P., et al. (2022). Identifying and treating resistant hypertension in PRECISION: A randomized long-term clinical trial with aprocitentan. Journal of Clinical Hypertension.
Idorsia Pharmaceuticals Ltd. (2024). Tryvio- aprocitentan tablet, film coated [package insert]. DailyMed.
Idorsia Pharmaceuticals Ltd. (2024). US FDA approves Idorsia’s once-daily Tryvio (aprocitentan) – the first and only endothelin receptor antagonist for the treatment of high blood pressure not adequately controlled in combination with other antihypertensives.
MedlinePlus. (2022). Hemoglobin test.
Whelton, P. K., et al. (2017). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension.
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