Indications

Pulmonary Hypertension (see Pulmonary Hypertension)

• Clinical Efficacy
  • xxxx

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Pharmacology

• Direct Vasodilation of Pulmonary and Systemic Arterial Vasculature
• Inhibition of Platelet Aggregation

Pharmacokinetics

• Biphasic
• Terminal Elimination Half-Life: 4 hrs

Metabolism

• Hepatic: predominantly (mainly via CYP2C8)
• Renal: only 4% if excreted in urine as unchanged drug

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Administration

• PO (Orenitram)
• Continuous SQ Infusion (Remodulin)
• Continuous IV Infusion (Remodulin)
• INH (Tyvaso)

Dose Adjustment

• Hepatic: reduce dose
• Renal: unknown

Pregnancy (see Pregnancy)

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Precautions

• Avoid Abrupt Discontinuation or Large Dose Reduction: due to risk of rebound pulmonary hypertension

Drug Interactions

• Gemfibrozil (see Gemfibrozil): P450 (CYP) 2C8 inhibitor which may increase exposure to trepostinil

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Adverse Effects

Cardiovascular Adverse Effects

• Hypotension (see Hypotension)
  • Epidemiology: associated with SQ and IV infusion
  • Physiology: vasodilation

Dermatologic Adverse Effects

• Infusion Site Pain/Reactions
  • Epidemiology: associated with subcutaneous infusion

Gastrointestinal Adverse Effects

• Diarrhea (see xxxx)
  • Epidemiology: associated with SQ and IV infusion
• Nausea (see xxxx)
  • Epidemiology: associated with SQ and IV infusion

Rheumatologic Adverse Effects

• Peripheral Edema (see xxxx)
  • Epidemiology: associated with SQ and IV infusion

Other Adverse Effects

• Jaw Pain
  • Epidemiology: associated with SQ and IV infusion
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References

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