How Does Tyvaso Work? Plus, 6 Other Tyvaso FAQs Answered

Tyvaso (treprostinil) is an inhaled medication for pulmonary arterial hypertension (PAH) and pulmonary hypertension (PH) associated with interstitial lung disease (ILD). These health conditions happen when there’s high blood pressure in the lungs, which can occur because of different causes.

If you’re living with one of these health conditions, you may experience symptoms such as fatigue, weakness, and shortness of breath, especially with physical activity. To help improve your ability to exercise and carry out daily tasks, your care team may recommend adding a medication like Tyvaso to your regimen.

So how exactly does Tyvaso work? And when should you expect to feel its effects? Find out below with answers to seven frequently asked questions about Tyvaso.

1. How does Tyvaso work?

Tyvaso is a prostacyclin analog, meaning that it’s a lab-made version of a natural molecule called prostacyclin. Prostacyclin relaxes and widens (dilates) your blood vessels. It also works on your platelets (blood clotting cells) to prevent them from clumping together.

When you inhale Tyvaso, it causes the blood vessels (arteries) in your lungs to relax, reducing pressure and resistance. It also helps your blood flow more freely, so you get more oxygen to your lungs. These effects can help improve your ability to exercise and complete daily tasks.

Tyvaso is the inhaled form of treprostinil. Treprostinil is also available as an oral pill (Orenitram) and an intravenous or subcutaneous (under the skin) infusion (Remodulin). Of these forms, Tyvaso is the only one approved for PH with ILD.

2. How long does it take Tyvaso to start working?

Tyvaso starts working in your lungs shortly after you inhale it. However, it can take some time before you see symptom improvement.

During initial clinical trials, people receiving Tyvaso for 12 weeks to treat PAH saw an improvement in how far they could walk in 6 minutes after 6 weeks of treatment. And they continued to see improvement through Week 12.

During a clinical trial involving people who had PH with ILD, participants receiving Tyvaso started to see an improvement in how far they could walk in 6 minutes after 4 weeks of treatment. But they saw a significant difference after 12 weeks.

You may not notice a difference in your symptoms when you first start taking Tyvaso. But patience and consistency are key. It may also take a few weeks to reach your target maintenance dosage. But, over time, you should start gradually seeing improvements in your capacity to exercise and do daily tasks. Your prescriber will also monitor you to make sure the medication is working properly.

3. How many puffs are in a Tyvaso inhaler?

The Tyvaso dry powder inhaler (DPI) comes in a kit that includes prefilled medication cartridges. The cartridges come in several different doses. You’ll typically start with the lowest dose and then gradually to higher ones.

There are a total of 112 cartridges in each Tyvaso inhaler maintenance kit. Use a new cartridge each time you take the medication. Since Tyvaso is usually taken 4 times per day, one kit should last you 28 days.

Good to know: Tyvaso also comes in ampules that are used with a portable nebulizer. Each carton contains 28 ampules, providing a 7-day supply of medication per carton.

4. Is Tyvaso a steroid?

Tyvaso is a prostacyclin analog, not a steroid. Tyvaso has anti-inflammatory effects, similar to steroids. And like Tyvaso, some steroids are inhaled. But these medications work differently and have different side effects.

The most common Tyvaso side effects include a cough, headaches, and shortness of breath. Steroids have many short- and long-term side effects, such as appetite changes, high blood glucose (sugar), and sweating.

5. Does Tyvaso need to be refrigerated?

The Tyvaso DPI inhaler doesn’t need to be refrigerated. You can store it at room temperature or keep it in the refrigerator. Each inhaler can be used for up to 7 days after the first use.

The cartridges for the inhaler are packaged in sealed blister strips (four cartridges per strip). Unopened blister strips last until their expiration date if kept in the refrigerator. But if you store them at room temperature, they must be used within 8 weeks. Once opened, the blister strips should be stored at room temperature and used within 3 days.

If you store your inhaler or unopened blister strips in the refrigerator, you should remove them from the refrigerator at least 10 minutes before you plan to use them. 

Below is a chart that summarizes the information above.

If you’re using the Tyvaso inhalation system (nebulizer), the ampules should be stored at room temperature. They come in a foil pouch (four ampules per pouch). Ampules inside an unopened foil pouch last until their expiration date. Once the foil pouch is opened, the ampules should be used within 7 days.

Any liquid you pour from an ampule into the nebulizer medicine cup to prepare for a dose should be used within 24 hours. It’s recommended to use 1 ampule per day for all 4 doses and to throw away any remaining medication in the ampule after all of your doses are taken.

6. Can you drink alcohol with Tyvaso?

Tyvaso isn’t known to directly interact with alcohol. But that doesn’t necessarily mean it’s safe to drink alcohol while taking Tyvaso.

If you’re living with PAH or PH with ILD, it’s generally a good idea to avoid or limit alcohol. Drinking alcohol, especially in large amounts, can increase your blood pressure. And this can put even more strain on your heart and possibly worsen your symptoms.

Talk to your prescriber if you have any questions about drinking alcohol while taking Tyvaso. They can help determine if there’s a safe amount for you to consume.

7. Can you just stop taking Tyvaso?

You should not abruptly stop taking Tyvaso without talking to your prescriber first. Doing so could cause your symptoms to get worse. If you happen to miss a dose, take the medication as soon as you remember and contact your prescriber.

If you’re considering stopping treatment with Tyvaso due to side effects, talk to your prescriber or pharmacist. Some side effects may resolve on their own. Others can be managed at home. In some cases, your prescriber may adjust your dosage to see if that makes a difference.

Why trust our experts?

Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain 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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