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Yutrepia
treprostinil inhaled
Adult Dosing .
Dosage forms: DPI: 26.5 mcg per cap, 53 mcg per cap, 79.5 mcg per cap, 106 mcg per cap
Special Note
- [strength clarification]
- Info: 1 cap = 2 breaths; doses expressed as treprostinil amount
pulmonary arterial HTN
- [treprostinil tx-naive pts]
- Dose: 79.5-106 mcg inhaled qid; Start: 26.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 30 mcg (5 breaths) or less per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 26.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 36-48 mcg (6-8 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 53 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 54-66 mcg (9-11 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 79.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 72-84 mcg (12-14 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 106 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 90-102 mcg (15-17 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 132.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 108 mcg (18 breaths) or more per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 159 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
pulmonary HTN, interstitial lung dz-associated
- [treprostinil tx-naive pts]
- Dose: 79.5-106 mcg inhaled qid; Start: 26.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 30 mcg (5 breaths) or less per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 26.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 36-48 mcg (6-8 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 53 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 54-66 mcg (9-11 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 79.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 72-84 mcg (12-14 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 106 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 90-102 mcg (15-17 breaths) per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 132.5 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
- [conversion from treprostinil NEB 108 mcg (18 breaths) or more per dose]
- Dose: 79.5-106 mcg inhaled qid; Start: 159 mcg inhaled 3-5x/day, may incr. by 26.5 mcg/dose qwk as tolerated; Max: 848 mcg/day
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised; Info: titrate slowly
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: hepatic impairment
- caution: asthma
- caution: reactive airway dz
- caution: COPD
- caution: pulmonary infection, acute
- caution: hypotension
- caution: bleeding risk
Drug Interactions .
Overview
treprostinil
prostacyclin vasodilator
- CYP2C8 substrate
- antiplatelet effects
- vasodilator agent
Avoid/Use Alternative
- aldesleukin
- captopril
- enoxaparin
- fondaparinux
- lofexidine
Monitor/Modify Tx
- abrocitinib
- acalabrutinib
- acebutolol
- ado-trastuzumab emtansine
- afatinib
- alfentanil
- alfuzosin
- aliskiren
- alteplase
- amantadine
- amifostine
- amiloride
- amitriptyline
- amlodipine
- amoxapine
- anacaulase topical
- anagrelide
- antithrombin
- apixaban
- apomorphine
- apraclonidine ophthalmic
- aprocitentan
- argatroban
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- articaine
- asenapine
- asparaginase
- aspirin
- atenolol
- avanafil
- avapritinib
- axitinib
- azilsartan medoxomil
- benazepril
- berberine
- betaxolol
- betaxolol ophthalmic
- bethanechol
- bevacizumab
- bexagliflozin
- binimetinib
- bisoprolol
- bivalirudin
- bortezomib
- brentuximab vedotin
- brexpiprazole
- brimonidine ophthalmic
- brimonidine topical
- bromelain
- bromfenac ophthalmic
- bromocriptine
- bumetanide
- bupivacaine
- bupivacaine liposomal
- buprenorphine
- butorphanol
- cabazitaxel
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- cabozantinib
- calaspargase
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- cangrelor
- cannabis
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- carfilzomib
- cariprazine
- carteolol ophthalmic
- carvedilol
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- cilostazol
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- codeine
- coenzyme Q-10
- collagenase clostridium histolyticum
- cysteamine
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- dalteparin
- danshen
- dapagliflozin
- dasatinib
- deferasirox
- defibrotide
- denileukin diftitox
- desflurane
- desipramine
- desvenlafaxine
- deuruxolitinib
- dexmedetomidine
- dexmedetomidine injection
- diclofenac
- diclofenac ophthalmic
- diclofenac topical
- diflunisal
- dihydrocodeine
- diltiazem
- dimethyl fumarate
- dinutuximab
- diosmin
- dipyridamole
- diroximel fumarate
- doxazosin
- doxepin
- dronabinol
- duloxetine
- edoxaban
- empagliflozin
- enalapril
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- encorafenib
- entacapone
- entrectinib
- eplerenone
- epoprostenol
- eptifibatide
- erlotinib
- ertugliflozin
- escitalopram
- esmolol
- ethacrynic acid
- ethanol
- etodolac
- evening primrose oil
- felodipine
- fenoldopam
- fenoprofen
- fentanyl
- fenugreek
- ferumoxytol
- flaxseed
- flibanserin
- fluoxetine
- fluphenazine
- flurbiprofen
- flurbiprofen ophthalmic
- fluvoxamine
- fosinopril
- foslevodopa
- fruquintinib
- furosemide
- garlic
- gefitinib
- gemfibrozil
- gemtuzumab ozogamicin
- gilteritinib
- ginkgo
- guanfacine
- haloperidol
- heparin
- hydralazine
- hydrochlorothiazide
- hydrocodone
- hydrocortisone
- hydromorphone
- ibrutinib
- ibuprofen
- ibuprofen lysine
- icosapent ethyl
- iloperidone
- iloprost
- iloprost inhaled
- imatinib
- imipramine
- indapamide
- indomethacin
- irbesartan
- iron sucrose
- isocarboxazid
- isoflurane
- isosorbide dinitrate
- isosorbide mononitrate
- isradipine
- ketoprofen
- ketorolac
- ketorolac ophthalmic
- labetalol
- landiolol
- lenvatinib
- levobunolol ophthalmic
- levodopa
- levomilnacipran
- levorphanol
- lidocaine
- lifileucel
- lisinopril
- losartan
- loxapine
- lubiprostone
- lumateperone
- lurasidone
- magnesium salicylate
- magnesium sulfate
- maraviroc
- meclofenamate
- mefenamic acid
- meloxicam
- meperidine
- mepivacaine
- methadone
- methohexital
- methotrexate
- methyl salicylate topical
- methyldopa
- methylene blue injection
- metolazone
- metoprolol
- midazolam
- milnacipran
- milrinone
- minoxidil
- mirtazapine
- mitotane
- moexipril
- molindone
- monomethyl fumarate
- morphine
- mycophenolate mofetil
- mycophenolic acid
- nabumetone
- nadolol
- nalbuphine
- naproxen
- nattokinase
- naxitamab
- nebivolol
- nepafenac ophthalmic
- niacin (vitamin B3)
- nicardipine
- nifedipine
- nilotinib
- nimodipine
- nintedanib
- nisoldipine
- nitric oxide
- nitrite
- nitroglycerin
- nitroprusside
- nortriptyline
- nusinersen
- obinutuzumab
- olanzapine
- oliceridine
- olmesartan medoxomil
- omega-3-acid
- opicapone
- opium
- oxaliplatin
- oxaprozin
- oxazepam
- oxycodone
- oxymorphone
- pacritinib
- paliperidone
- palopegteriparatide
- paroxetine
- pazopanib
- pegaspargase
- penicillin G
- pentamidine
- pentazocine
- pentobarbital
- pentosan polysulfate sodium
- pentoxifylline
- perindopril
- perphenazine
- phenelzine
- phenobarbital
- phenoxybenzamine
- phentolamine
- pindolol
- piperacillin
- piroxicam
- pirtobrutinib
- plasminogen, human
- ponatinib
- porfimer
- pralsetinib
- pramipexole
- prasugrel
- prazosin
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- propranolol
- protriptyline
- quetiapine
- quinapril
- ramipril
- ramucirumab
- ranibizumab
- rasagiline
- regorafenib
- remifentanil
- remimazolam
- resveratrol
- reteplase
- revakinagene taroretcel
- riociguat
- risperidone
- rivaroxaban
- ropinirole
- ropivacaine
- rotigotine transdermal
- sacubitril
- safinamide
- salsalate
- saw palmetto
- selegiline
- selegiline transdermal
- selpercatinib
- selumetinib
- sertraline
- sevoflurane
- sildenafil
- silodosin
- sirolimus albumin-bound
- sodium ferric gluconate complex
- sorafenib
- sotagliflozin
- sotalol
- sotatercept
- sparsentan
- spironolactone
- sufentanil
- sulindac
- sunitinib
- tadalafil
- tagraxofusp
- tamsulosin
- tapentadol
- taurine
- telmisartan
- temsirolimus
- tenecteplase
- terazosin
- thalidomide
- thioridazine
- thiothixene
- ticagrelor
- timolol
- timolol ophthalmic
- tipranavir
- tirofiban
- tisotumab vedotin
- tivozanib
- tizanidine
- tolcapone
- tolmetin
- torsemide
- tovorafenib
- tramadol
- trametinib
- trandolapril
- tranylcypromine
- trazodone
- triamterene
- trifluoperazine
- trimipramine
- upadacitinib
- vadadustat
- valproic acid
- valsartan
- vandetanib
- vardenafil
- venlafaxine
- verapamil
- vericiguat
- vilazodone
- vinpocetine
- vorapaxar
- vortioxetine
- vosoritide
- warfarin
- willow bark
- yohimbe
- zanubrutinib
- ziprasidone
- ziv-aflibercept
Caution Advised
- verteporfin
Adverse Reactions .
Serious Reactions
- hypotension, severe
- syncope
- bleeding
- angioedema
- bronchospasm
Common Reactions
- cough
- headache
- throat irritation
- pharyngolaryngeal pain
- nausea
- dizziness
- flushing
- diarrhea
- dyspnea (DPI form)
- syncope
- myalgia
- bone pain
- jaw pain
Safety/Monitoring .
Monitoring Parameters
BP
Pregnancy/Lactation .
Pregnancy
Clinical Summary
benefits outweigh risks during pregnancy; no human data available w/ inhaled form, though risk of fetal harm not expected based on limited human data w/ injectable form
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available w/ inhaled form, though risk of infant harm not expected based on drug properties; no known risk of infant harm based on limited human data w/ injectable form; no human data available to assess effects on milk production
Pharmacology .
Metabolism: liver extensively; CYP450: 2C8 (primary), 2C9 substrate
Excretion: urine 79% (4% unchanged), feces 13%; Half-life: 27-50min
Subclass: Interstitial Lung Disease ; Pulmonary Arterial Hypertension (PAH)
Mechanism of Action
dilates pulmonary and systemic vessels, inhibits platelet aggregation and smooth muscle cell proliferation (prostacyclin analog)
Formulary .
No Formulary Selected
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