Treprostinil (Remodulin)

What treprostinil (as treprostinil sodium) is and how it works

Treprostinil is a man-made version of prostacyclin, a substance the body makes naturally to widen blood vessels. Given as a continuous infusion, it widens the blood vessels in the lungs and reduces the workload on the heart in pulmonary arterial hypertension (PAH), a serious condition of high blood pressure in the arteries of the lungs. (1) (2) (4)

Treprostinil by continuous infusion (Remodulin) is delivered day and night through a small pump, either just under the skin (subcutaneous) or into a vein through a permanent catheter (intravenous). Two safety facts are especially important: first, this medicine should never be stopped suddenly or have its dose sharply reduced without your care team's direction, since real, serious worsening of PAH symptoms -- and, in a small number of cases, death -- has been reported in association with abrupt discontinuation, even though a direct cause-and-effect 'rebound' mechanism has not been established by every regulator that has reviewed the evidence. Second, if you receive treprostinil into a vein through a permanent catheter, there is a real risk of serious, potentially fatal bloodstream infection, which is why subcutaneous (under-the-skin) delivery is preferred whenever it can be tolerated.

Mechanism of action: how treprostinil (as treprostinil sodium) works

Treprostinil is a synthetic tricyclic benzidine analogue of prostacyclin (PGI2), acting as a direct vasodilator of the pulmonary and systemic arterial vascular beds and an inhibitor of platelet aggregation. (4)

What treprostinil (as treprostinil sodium) is used for

Before taking treprostinil (as treprostinil sodium)

Do not take / not appropriate for

• Do not receive treprostinil if you have a known hypersensitivity to the drug, its excipients, or structurally related compounds. (all countries) (4)

Tell your clinician about

• If you have liver problems, since treprostinil clearance can be reduced by up to 80% in hepatic impairment, requiring a lower starting dose and slower increases.
• If you have low blood pressure, since treprostinil can cause or worsen low blood pressure (hypotension).
• If you take blood thinners or have a bleeding disorder, since treprostinil reduces platelet clumping and can increase bleeding risk.
• If you have kidney problems, since dosing may need to be more conservative.
• If you develop signs of fluid in the lungs (worsening shortness of breath) while on treatment, since this can indicate an underlying condition (pulmonary veno-occlusive disease) that needs urgent evaluation.
• Your ability and your caregiver's ability to manage a continuous infusion pump and catheter care, since treatment is often needed for prolonged periods, possibly years.

How to take treprostinil (as treprostinil sodium)

• Treprostinil for PAH is given as a continuous infusion, 24 hours a day, using a small portable pump -- it is not a medicine you take as an occasional dose.
• Subcutaneous (under-the-skin) delivery is the preferred route because it carries a lower infection risk than intravenous delivery; the intravenous route is generally reserved for when subcutaneous delivery cannot be tolerated because of site pain or reaction.
• Always have a backup infusion pump and supplies immediately available, since any interruption in delivery needs to be addressed quickly.
• NEVER stop or sharply reduce your infusion on your own, even briefly -- always follow your care team's specific instructions, and if an accidental interruption happens, contact your care team promptly about restarting.
• Use careful, sterile (aseptic) technique when preparing and handling your infusion system to reduce infection risk, as trained by your care team.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

A missed or interrupted infusion is a medical concern, not a routine missed dose -- contact your care team promptly if your infusion is interrupted for any reason, rather than waiting or restarting on your own without guidance.

Overdose

Seek urgent medical attention if an overdose is suspected. Symptoms may include flushing, headache, nausea, vomiting, diarrhoea, or low blood pressure (dizziness, fainting). Do not wait for symptoms to worsen before contacting your care team or emergency services. (2)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Blood thinners (anticoagulants) and other medicines that increase bleeding risk: tell your care team about all medicines you take, since combined use may increase bleeding risk. (1)
• Other blood-pressure-lowering medicines: may increase the risk of low blood pressure when combined with treprostinil. (2)
• Medicines that affect the CYP2C8 liver enzyme (e.g. gemfibrozil, rifampin): can significantly increase or decrease treprostinil levels; your care team may need to adjust your dose. (4)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Baseline blood pressure and assessment for conditions that increase bleeding or infection risk.
• Assessment of your (or your caregiver's) ability to manage a continuous infusion pump and catheter care for a prolonged period, possibly years.
• Liver function assessment, since dosing depends on hepatic status.

During treatment

• Regular monitoring for infusion-site problems, signs of infection (especially with intravenous delivery), and blood pressure.
• Prompt reporting of any interruption in infusion delivery to your care team.
• Never adjust your own dose or stop treatment without your care team's specific instruction.

Storage

Store as directed by your pharmacy/care team; inspect the solution for clarity, particulate matter, discoloration, or leakage before use, and do not use if any of these are present.

Frequently asked questions

References

1. REMODULIN (treprostinil) injection, solution -- full prescribing informationDailyMed (U.S. National Library of Medicine) -- FDA-approved prescribing information · United States · dated 2025-01-01 · accessed 2026-07-31 · source 1
2. Treprostinil 1 mg/ml Solution For Infusion -- SmPCelectronic medicines compendium (emc), United Kingdom -- Summary of Product Characteristics · United Kingdom · dated 2025-01-01 · accessed 2026-07-31 · source 2
3. REMODULIN (treprostinil) -- medicine extractBase de Donnees Publique des Medicaments (ANSM / French Ministry of Health) -- official French medicines database · European Union (France) · dated 2005-02-28 · accessed 2026-07-31 · source 3
4. REMODULIN (treprostinil) Injection Solution -- Product Monograph, Control Number 302563Health Canada -- Product Monograph (United Therapeutics Corp.) · Canada · dated 2026-04-21 · accessed 2026-07-31 · source 4
5. Treprostinil -- Healthdirect medicine listing; TGA ARTG search resultsHealthdirect Australia (government-funded health information service) and Therapeutic Goods Administration (TGA) search results · Australia · accessed 2026-07-31 · source 5
6. Direct Medsafe site and database search for treprostinilMedsafe (New Zealand Medicines and Medical Devices Safety Authority) · New Zealand · accessed 2026-07-31 · source 6

Brand names by country

Single-ingredient treprostinil (as treprostinil sodium) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries