Treprostinil is a medication a doctor may prescribe to a patient with pulmonary arterial hypertension (PAH), a form of high blood pressure that can lead to heart failure if not treated. The medication comes in the form of an injectable solution, and patients take it at home with the assistance of an infusion pump to provide a continuous dose of the drug. Usually, doctors will consider more conservative treatments before turning to treprostinil, as patients will need to take this medication for several years and can be at risk of complications associated with the infusion pump and accessories.
This medication forces the pulmonary artery to dilate, decreasing blood pressure. Patients on treprostinil will be able to exercise more comfortably and can avoid complications of PAH like damage to the heart. Usually, the doctor will start giving the drug in a hospital setting, where nurses can monitor the patient during the adjustment period. The dosage can be changed as the patient starts to respond until the doctor finds a satisfactory infusion rate and feels comfortable sending the patient home.
Patients on treprostinil will undergo a procedure where a doctor places a line to provide a route for delivery. The infusion pump is portable and can be easily carried or worn. Periodically, the patient fills a reservoir with more treprostinil solution so the infusion will continue without interruption. Patients need to exercise special care when handling the pump and infusion site to reduce the risk of infections or situations where the line slips out of position.
Common side effects of this medication can include redness and swelling around the infusion site, nausea or vomiting, rashes, and joint pain. If patients notice swelling in their extremities, experience shortness of breath, or feel like they are going to faint, these are signs that the treprostinil is not working, and the patient's PAH is getting worse or not responding to treatment. The patient should report the symptoms to a doctor so an evaluation can take place to determine why the patient isn't responding.
This medication also changes the blood chemistry. Patients with a history of clotting disorders could be at risk of complications from treprostinil and should be sure to discuss their complete medical history with the doctor. Treprostinil can also interact badly with other drugs intended to control blood pressure or heart rate. Patients should go over all the medications they take, including over the counter drugs, before starting this drug therapy to determine if it is a good option for their needs.