Treprostinil Injection

What is Treprostinil Injection?
Treprostinil Injection is a synthetic analogue of prostacyclin (8$PGI_2$).9 It belongs to the class of vasodilators and is a critical long-term therapy for patients with Pulmonary Arterial Hypertension (WHO Group 1).10 It is designed to reduce the workload on the heart and improve exercise capacity in patients who remain symptomatic despite other treatments.11
 
Uses of Treprostinil Injection
Treatment of Pulmonary Arterial Hypertension (PAH) to diminish symptoms associated with exercise.12
 
Improvement of NYHA Functional Class in patients with PAH.
Reduction of the rate of clinical deterioration and hospitalization.13
 
Transition therapy for patients who need to switch from epoprostenol but require a more stable prostacyclin analogue.14
 
Management of digital ulcers in patients with systemic sclerosis (off-label/investigational in some regions).15
 
How Does Treprostinil Injection Work?
Treprostinil works by directly dilating the pulmonary and systemic arterial vascular beds. It binds to specific prostacyclin receptors, leading to an increase in intracellular cyclic AMP.16 This causes smooth muscle relaxation, inhibits platelet aggregation, and may also inhibit smooth muscle cell proliferation, thereby reducing pulmonary artery pressure and improving blood flow.17
 
FAQs on Treprostinil Injection
1. How is Treprostinil Injection administered?
It is administered as a continuous infusion, either subcutaneously (SC) or intravenously (IV).18 Subcutaneous administration is often preferred because it avoids the risks associated with central venous catheters, such as sepsis or line dislodgement.19 It is delivered using a small, dedicated infusion pump.
2. What is the stability of Treprostinil compared to Epoprostenol?
One of the primary advantages of Treprostinil is its chemical stability.20 Unlike epoprostenol, which requires a cold chain and must be kept on ice during infusion, Treprostinil is stable at room temperature and does not require cooling during use.21
3. What should a patient do if the infusion pump stops?
Treprostinil has a short half-life (approximately 4 hours), but an interruption in delivery is a medical emergency.22 Patients must be trained to restart the pump immediately or switch to a backup pump to avoid a sudden rebound of pulmonary hypertension symptoms.
4. What are the common side effects at the injection site?
For patients receiving subcutaneous infusion, infusion site pain and reaction (redness or swelling) are very common.23 This is often managed with site rotation and topical or oral analgesics, rather than discontinuing the life-saving medication.
Therapeutic Category
Cardiovascular (Antihypertensives / Vasodilators)
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