Article · Wikipedia archive · Last revised Jul 18, 2026

Treprostinil

Treprostinil, sold under the brand names Remodulin for infusion, Orenitram for oral, and Tyvaso for inhalation among others, is a vasodilator that is used for the treatment of pulmonary arterial hypertension.

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Treprostinil
Clinical data
Trade namesRemodulin, Orenitram, Tyvaso, others
AHFS/Drugs.comMonograph
MedlinePlusa622038
License data
Pregnancy
category
  • AU: B3
Routes of
administration		Subcutaneous, intravenous, inhalation, by mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability~100%
MetabolismSubstantially metabolized by the liver
Elimination half-life4 hours
ExcretionUrine (79% of administered dose is excreted as 4% unchanged drug and 64% as identified metabolites); feces (13%)
Identifiers
  • (1R,2R,3aS,9aS)-[[2,3,3a,4,9,9a-Hexahydro-2-hydroxy-1-[(3S)-3-hydroxyoctyl]-1H-benz[f]inden-5-yl]oxy]acetic acid
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.236.149
Chemical and physical data
FormulaC23H34O5
Molar mass390.520 g·mol−1
  • InChI=1S/C23H34O5/c1-2-3-4-7-17(24)9-10-18-19-11-15-6-5-8-22(28-14-23(26)27)20(15)12-16(19)13-21(18)25/h5-6,8,16-19,21,24-25H,2-4,7,9-14H2,1H3,(H,26,27)/t16-,17-,18+,19-,21+/m0/s1 checkY
  • Key:PAJMKGZZBBTTOY-ZFORQUDYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Treprostinil, sold under the brand names Remodulin for infusion, Orenitram for oral, and Tyvaso for inhalation among others, is a vasodilator that is used for the treatment of pulmonary arterial hypertension.7

Treprostinil was approved for use in the United States in May 2002.8

Medical uses

Treprostinil is indicated for the treatment of pulmonary arterial hypertension in people with NYHA Class II-IV symptoms to diminish symptoms associated with exercise.1

Treprostinil inhalation solution and treprostinil inhalation powder are indicated for the treatment of people with pulmonary arterial hypertension (WHO Group 1) to improve exercise ability; and people with pulmonary hypertension associated with interstitial lung disease (WHO Group 3) to improve exercise ability.34

In the European Union, treprostinil (Trepulmix) is indicated for the treatment of adults with WHO Functional Class III or IV and inoperable chronic thromboembolic pulmonary hypertension;6 or persistent or recurrent chronic thromboembolic pulmonary hypertension after surgical treatment to improve exercise capacity.6

Adverse effects

  • Since treprostinil is a vasodilator, its antihypertensive effect may be compounded by other medications that affect the blood pressure, including calcium channel blockers, diuretics, and other vasodilating agents.9
  • Because of treprostinil's inhibiting effect on platelet aggregation, there is an increased risk of bleeding, especially among patients who are also taking anticoagulants.9

Common side effects depending on route of administration:

  • 85% of patients report pain or other reaction at the infusion site.9

History

In 1976, the first paper on prostacyclin was published.10

Treprostinil (Remodulin) was approved for medical use in the United States in May 2002,8 and again in July 2018.11

Treprostinil (Tyvaso), as inhalation solution, was approved for medical use in the United States in July 2009,12 and again in April 2021.13

Treprostinil (Orenitram), as extended release tablets, was approved for medical use in the United States in December 2013.14

Treprostinil (Trepulmix) was authorized for medical use in the European Union in April 2020.6 Trepulmix is a hybrid medicine that is similar to the reference medicine Remodulin.6 It contains the same active substance, but it is used for treating a different form of pulmonary hypertension.6

Treprostinil (Tyvaso DPI), as inhalation powder, was approved for medical use in the United States in May 2022.1516

Treprostinil (Yutrepia), as inhalation powder, was approved for medical use in the United States in June 2025.51718

Research

Treprostinil therapy may be effective in treating Degos disease.19

References

References

  1. "Remodulin- treprostinil injection, solution; Sterile diluent for remodulin- water injection, solution". DailyMed. 9 October 2023. Archived from the original on 21 May 2024. Retrieved 21 May 2024.
  2. "Orenitram- treprostinil tablet, extended release; Orenitram- treprostinil kit". DailyMed. 7 November 2023. Archived from the original on 21 May 2024. Retrieved 21 May 2024.
  3. "Tyvaso- treprostinil inhalant". DailyMed. 8 December 2023. Retrieved 21 May 2024.
  4. "Tyvaso DPI- treprostinil inhalant; Tyvaso DPI- treprostinil kit". DailyMed. 26 January 2024. Archived from the original on 21 May 2024. Retrieved 21 May 2024.
  5. "Yutrepia- treprostinil capsule". DailyMed. 2 June 2025. Retrieved 6 July 2025.
  6. "Trepulmix EPAR". European Medicines Agency (EMA). 29 January 2020. Archived from the original on 3 August 2020. Retrieved 9 April 2020. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  7. Torres F, Rubin LJ (January 2013). "Treprostinil for the treatment of pulmonary arterial hypertension". Expert Review of Cardiovascular Therapy. 11 (1): 13–25. doi:10.1586/erc.12.160. PMID 23259441. S2CID 29661141.
  8. "Drug Approval Package: Remodulin (Treprostinil Sodium) NDA #021272". U.S. Food and Drug Administration (FDA). 31 July 2002. Archived from the original on 12 March 2020. Retrieved 9 April 2020.
  9. Kumar P, Thudium E, Laliberte K, Zaccardelli D, Nelsen A (December 2016). "A Comprehensive Review of Treprostinil Pharmacokinetics via Four Routes of Administration". Clinical Pharmacokinetics. 55 (12): 1495–1505. doi:10.1007/s40262-016-0409-0. PMC 5107196. PMID 27286723.
  10. Moncada S, Gryglewski R, Bunting S, Vane JR (October 1976). "An enzyme isolated from arteries transforms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation". Nature. 263 (5579): 663–665. Bibcode:1976Natur.263..663M. doi:10.1038/263663a0. PMID 802670. S2CID 4279030.
  11. "Drug Approval Package: Remodulin". U.S. Food and Drug Administration (FDA). 7 February 2019. Archived from the original on 29 March 2021. Retrieved 9 April 2020.
  12. "Drug Approval Package: Tyvaso (Treprostinil) Inhalation Solution NDA #022387". U.S. Food and Drug Administration (FDA). 27 September 2017. Archived from the original on 31 March 2021. Retrieved 9 April 2020.
  13. "United Therapeutics Announces FDA Approval and Launch of Tyvaso for the Treatment of Pulmonary Hypertension Associated with Interstitial Lung Disease" (Press release). United Therapeutics. 1 April 2021. Retrieved 20 June 2025 – via PR Newswire.
  14. "Drug Approval Package: Orenitram (Treprostinil) Extended Release Tablets NDA #203496". U.S. Food and Drug Administration (FDA). 23 July 2014. Archived from the original on 14 August 2020. Retrieved 9 April 2020.
  15. "Drug Approval Package: Tyvaso DPI". U.S. Food and Drug Administration (FDA). 6 July 2022. Archived from the original on 28 September 2024. Retrieved 20 June 2025.
  16. "United Therapeutics Announces FDA Approval of Tyvaso DPI" (Press release). United Therapeutics. 24 May 2022. Retrieved 20 June 2025 – via Business Wire.
  17. "Letter to Kristan Amicone about NDA Approval for Yutrepia" (PDF). www.accessdata.fda.gov. 23 May 2025.
  18. "U.S. FDA Approves Liquidia's Yutrepia (treprostinil) Inhalation Powder for Patients with Pulmonary Arterial Hypertension (PAH) and Pulmonary Hypertension Associated with Interstitial Lung Disease (PH-ILD)" (Press release). Liquidia Technologies. 23 May 2025. Archived from the original on 24 May 2025. Retrieved 25 May 2025 – via GlobeNewswire.
  19. Shapiro LS, Toledo-Garcia AE, Farrell JF (April 2013). "Effective treatment of malignant atrophic papulosis (Köhlmeier-Degos disease) with treprostinil--early experience". Orphanet Journal of Rare Diseases. 8: 52. doi:10.1186/1750-1172-8-52. PMC 3636001. PMID 23557362.
Further reading

Further reading

  • Narine L, Hague LK, Walker JH, Vicente C, Schilz R, Desjardins O, et al. (December 2005). "Cost-minimization analysis of treprostinil vs. epoprostenol as an alternate to oral therapy non-responders for the treatment of pulmonary arterial hypertension". Current Medical Research and Opinion. 21 (12): 2007–2016. doi:10.1185/030079905X75104. PMID 16368052. S2CID 13162585.
External links