Tyvaso (treprostinil) is a medication prescribed for adults to treat high blood pressure in the lungs. This medication works to open up blood vessels leading to the lungs to help your body get more oxygen. Tyvaso (treprostinil) is available as a nebulizer and a dry powdered inhaler (DPI). This medication is typically only available at specialty pharmacies, so your provider will need to help set that up for you.
High blood pressure in the lungs, including:
Pulmonary hypertension from severe lung problems
Tyvaso (treprostinil) is a man-made version of prostacyclin, a natural hormone in your body that helps to open up the blood vessels. Tyvaso (treprostinil) allows your blood to flow better into the lungs, which lowers the lung blood pressure and helps your body get more oxygen. This leads to less strain on the heart, better ability to exercise, and lower risk of PH getting worse.
Source: DailyMed
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
fainting
feeling of warmth
redness of the face, neck, arms and occasionally, upper chest
Incidence not known
Bloody nose
chest pain or tightness
chills
coughing or spitting up blood
difficulty or trouble breathing
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
unusual bleeding or bruising
Get emergency help immediately if any of the following symptoms of overdose occur:
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:
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.
Improve the distance people with PH could walk in 6 minutes
Can be inhaled directly into the lungs
Available through both a DPI and a nebulizer
Need to use 4 times a day
Not approved for children under 18 years old
Commonly causes cough as a side effect
How to load Tyvaso (treprostinil) DPI: Open the mouthpiece of the inhaler, insert the cartridge with the cup facing down. Make sure the tip of the cartridge is aligned with the inhaler. Close the mouthpiece until you feel a snap.
How to use Tyvaso (treprostinil) DPI: Keep the inhaler level while taking the mouthpiece cover off of the inhaler. When you're ready, exhale fully. Then, put the mouthpiece into your mouth and inhale deeply. Move the inhaler away from your mouth afterwards and hold your breath for as long as you can. Repeat the steps if your dose requires you to use more than one cartridge.
You can store the Tyvaso (treprostinil) blister cards of cartridges at room temperature or in the refrigerator before using. If stored at room temperature, cartridges in an unopened blister strip expire after 5 weeks. Once the blister strip is opened, cartridges expire after 3 days.
If you store the Tyvaso (treprostinil) blister cards of cartridges in the refrigerator, cartridges in an unopened blister strip are good until the expiration date on the package. Once the blister strip has been opened or stored at room temperature, don't put it into the refrigerator.
If cartridges and mouthpiece are refrigerated, keep them at room temperature for 10 minutes before using to avoid condensation inside the inhaler.
Used Tyvaso (treprostinil) mouthpiece should be thrown away in regular trash after one week.
How to set up Tyvaso (treprostinil) nebulizer: Wash and dry your hands, then fill the white water chamber inside the nebulizer with 45 mL of distilled water (between the silver sensor and the blue ring). Put an empty, new medicine cup inside the white water chamber, make sure the tip of the medicine cup is below the water level.
How to load Tyvaso (treprostinil) nebulizer: Take out an ampule of Tyvaso (treprostinil) and twist off the cap. Pour the medication into the cup by squeezing the ampule, then check to make sure it's empty. The mouthpiece contains 3 parts: the filter, the port, and the opening. Connect the parts together according to directions from the manufacturer.
If any Tyvaso (treprostinil) gets onto your skin, wash it off right away. This medication can cause skin irritations.
Make sure to change out the filter membrane every day.
How to use Tyvaso (treprostinil) nebulizer: Turn on the nebulizer according to directions from the manufacturer. Make sure your Tyvaso (treprostinil) nebulizer is programmed to the correct number of breaths that your provider prescribed per dose.
Store Tyvaso (treprostinil) nebulizer vials at room temperature before using. If the vial is opened, make sure to use the medication within a day.
Keep unopened vials in the original foil wrapper to protect them from light. If the medication is taken out of the wrapper, use it within 7 days.
Use the Treatment Tracker that comes with Tyvaso (treprostinil) nebulizer to record the number of breaths you take during each treatment session, and bring it with you to your appointments.
If Tyvaso (treprostinil) solution or dry powder spills onto your skin during treatment, make sure to wash your hands with water right away.
Before starting any new medications, speak with your provider first. Some medications can interact with Tyvaso (treprostinil) and lead to more side effects.
Tyvaso (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 factor: History of low blood pressure
Tyvaso (treprostinil) can widen your blood vessels, which can cause your blood pressure to drop in your lungs as well as throughout your body. The risk is higher if you have a history of low blood pressure or if you take other medications to lower your blood pressure. Don't drive a car or operate machinery right after using this medication. If you experience symptoms such as lightheadedness or dizziness, let your provider know right away.
Risk factor: Taking other medications that prevent blood clots
Tyvaso (treprostinil) can prevent blood clots from forming in your body, which can raise your risk of bleeding. The risk is higher if you take a blood thinner, such as clopidogrel (Plavix). Be careful of cuts and injuries since you might bleed more easily. Get medical attention right away if you have bleeding that doesn't stop or bruising that won't go away.
Risk factor: History of breathing problems
Although rare, Tyvaso (treprostinil) can worsen symptoms of asthma or chronic obstructive pulmonary disease (COPD) by tightening the airways. This is more likely to happen if you have a history of asthma or COPD. If you feel more wheezing, shortness of breath, or coughing after using Tyvaso (treprostinil), stop this medication right away and speak to your healthcare provider.
Some medications can interfere with how your body gets rid of Tyvaso (treprostinil). Depending on if they boost or block how Tyvaso (treprostinil) gets removed, the medications can affect the amount of Tyvaso (treprostinil) in your body, how well it works, and the risk of side effects. For example, rifampin (Rifadin) can lower the amount of Tyvaso (treprostinil) in your body and cause the medication to not work as well. While gemfibrozil (Lopid) can raise the amount of Tyvaso (treprostinil) in your body and raise the risk of side effects, such as cough and headache. Make sure to let your provider know what other medications you're taking so they can check to see if they're safe for you.
Tyvaso (treprostinil) nebulizer:
Tyvaso (treprostinil) nebulizing solution comes in ampules. Each ampule contains 1.74 mcg of treprostinil. One ampule contains enough medication for one day of treatment, no matter how many breaths you're prescribed.
You'll have one treatment session 4 times a day, about 4 hours apart. The typical starting dose is to take 3 breaths by mouth during each treatment session. Your provider will raise your dose every 1-2 weeks until you reach a maintenance dose of 9-12 breaths with each treatment session.
Tyvaso (treprostinil) DPI comes in single-dose cartridges.
The typical starting dose is to inhale one 16 mcg cartridge four times a day, about 4 hours apart. Your provider will raise your dose every 1-2 weeks until you reach a maintenance dose of one 48 mcg or 64 mcg cartridge four times a day.
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.
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.
High blood pressure in the lungs, including:
Pulmonary hypertension from severe lung problems
Pulmonary arterial hypertension (PAH)
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American Lung Association. (n.d.). Pulmonary arterial hypertension (PAH).
American Lung Association. (n.d.). Pulmonary hypertension.
National Organization for Rare Disorders. (2021). Pulmonary arterial hypertension.
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