Lindsay Cook, PharmD is a board-certified consultant pharmacist.
Orenitram (treprostinil) is a prescription medication used to treat pulmonary arterial hypertension (PAH) in adults.
Orenitram is a tricyclic analog of prostacyclin , a hormone that is produced in blood vessels. As a vasodilator , it works by directly widening the blood vessels (vasodilation) of the lungs and other parts of the body to improve blood flow. It also stops platelets from clumping together in the blood (platelet aggregation), and it hinders the growth and division of smooth muscle cells (smooth muscle proliferation). All of these mechanisms of action help delay disease progression and improve exercise capacity for people with PAH.
Orenitram is available in extended-release form as a tablet. Treprostinil is also available in inhaled and intravenous forms; however, this article focuses on the oral version.
Brand Name(s): Orenitram
Controlled Substance: N/A
Dosage Form(s): Extended-release tablet
Orenitram is used to treat pulmonary arterial hypertension (PAH) in adults.
PAH is a form of pulmonary hypertension (blood pressure in the lungs). It occurs when the small arteries in the lungs thicken and narrow, blocking blood flow. This, in turn, causes the heart to work harder to pump blood to the rest of the body.
Orenitram helps widen blood vessels, and it inhibits platelet aggregation and smooth muscle cell proliferation, thereby improving blood flow and lessening the workload for your heart.
Take Orenitram with food as prescribed by your healthcare provider. Swallow the tablets whole; do not crush, split, or chew them.
When starting Orenitram, your healthcare provider may frequently change your dose to find out which works best for you. Part of the tablet may pass into your stool. Do not be alarmed if this happens; this is normal.
Store Orenitram in a closed container at room temperature (68 F to 77 F), away from heat, moisture, and direct light. Do not keep the tablets in the bathroom.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
The most common side effects associated with Orenitram include:
Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Orenitram may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program online or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
There is not enough evidence to determine whether taking Orenitram during pregnancy poses any risks to the fetus. However, PAH itself has been shown to carry potential risks to the pregnant patient and the fetus. Talk to your healthcare provider if you are pregnant or breastfeeding.
Certain factors may affect how you take this medication, potentially requiring a dosage adjustment. Talk to your healthcare provider if any of the following circumstances apply to you:
Moreover, your healthcare provider will modify your dose if you transition from an intravenous or subcutaneous administration route to the oral version of treprostinil.
If you miss your dose of Orenitram, take it as soon as you remember. If it is almost time for your next dose, wait until then and take your regular dose. Do not take extra to make up for a missed dose. If you miss two or more doses, call your healthcare provider, as you may need a dose adjustment.
Signs of an overdose with Orenitram include:
Overdose symptoms are usually treated supportively, but seek medical attention if these symptoms become severe.
If you think you or someone else may have overdosed on Orenitram, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Orenitram, call 911 immediately.
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects. Blood tests may be needed to check for unwanted effects.
You should not use other medicines that also contain treprostinil. This includes Remodulin® or Tyvaso®. Using these medicines together may increase your chance for more serious side effects.
Do not suddenly stop using this medicine. Stopping or changing the dose of this medicine suddenly may bring on symptoms of your condition and can be dangerous. Check with your doctor before stopping or changing your dose.
This medicine may increase risk of bleeding, especially in patients receiving blood thinners. Tell your doctor if you are taking a blood thinner (such as warfarin).
While taking the medicine, part of the tablet may pass into your stools. This is usually normal. But, if you have diverticulosis (bowel problem), the tablet shell may get stuck in a blind pouch or diverticulum in your intestine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Do not take Orenitram if you have advanced liver disease. Orenitram is metabolized in the liver; therefore, drug clearance is significantly affected by the degree of liver impairment.
Orentram can interact with the following medications:
Talk to your healthcare provider if you use any of the above-listed medications. This is not an all-inclusive list of drugs that can interact with Orenitram. Ask your healthcare provider or pharmacist before using any other drugs or herbal products with Orenitram.
Orenitram is a derivative of epoprostenol; therefore, the medication epoprostenol (e.g., Flolan, Veletri) is similar to Orenitram. Epoprostenol also treats pulmonary hypertension.
Additionally, other vasodilators used to treat PAH include:
Orenitram is a prescription medication used to treat pulmonary arterial hypertension.
Orenitram belongs to a class of medications known as vasodilators. It causes direct vasodilation (widening) of the pulmonary and systemic arterial blood vessels. Additionally, it stops platelets from clumping together in the blood and blocks the growth and division of smooth muscle cells.
Do not abruptly stop taking Orenitram. Your healthcare provider will need to slowly decrease (taper) your dose before you can stop taking Orenitram completely.
PAH is a serious health condition; however, Orenitram and other treatments can help manage the condition and prevent it from progressing. Make sure to take your medication as prescribed; do not stop taking it abruptly, as this can worsen your symptoms.
In addition to pharmacologic treatment, lifestyle changes can play a role in maintaining your overall health with PAH. Instilling the following habits in your day-to-day life may be useful in staying healthy:
Additionally, Orenitram can increase your risk of bleeding. Report any signs or symptoms of bleeding to your healthcare provider.
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
Food and Drug Administration. Orenitram label.
Kumar P, Thudium E, Laliberte K, Zaccardelli D, Nelsen A. A comprehensive review of treprostinil pharmacokinetics via four routes of administration. Clin Pharmacokinet. 2016;55(12):1495-1505. doi:10.1007/s40262-016-0409-0
American Lung Association. Learn about pulmonary arterial hypertension.
Pugliese SC, Bull TM. Clinical use of extended-release oral treprostinil in the treatment of pulmonary arterial hypertension. Integr Blood Press Control. 2016;9:1-7. doi:10.2147/IBPC.S68230
Kumar P, Thudium E, Laliberte K, Zaccardelli D, Nelsen A. A comprehensive review of treprostinil pharmacokinetics via four routes of administration. Clin Pharmacokinet. 2016;55(12):1495-1505. doi:10.1007/s40262-016-0409-0
American Lung Association. Treating and managing pulmonary arterial hypertension.
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.