What Is Tyvaso?
Tyvaso (treprostinil) is a prescription-only medication used to help improve the symptoms of a medical condition known as pulmonary arterial hypertension (PAH).
Pulmonary hypertension means you have high blood pressure in the arteries that carry blood to your lungs. This is a serious medical condition that is accompanied by bothersome symptoms.
When high blood pressure is in these arteries, the blood vessels are narrowed, meaning less blood and oxygen can get to the lungs. As the disease progresses, it leads to symptoms such as shortness of breath, tiredness, and difficulty breathing upon exertion.
Treprostinil widens the blood vessels, lowering the pressure in the arteries for the lungs and helping to alleviate the symptoms of PAH.
Tyvaso is taken as an inhalation that you breathe into your lungs. You will use an inhalation system to administer the medication, which comes as an inhalation solution (liquid) or a powder.
Drug Facts
Generic Name: Treprostinil
Brand Name(s): Tyvaso, Tyvaso DPI
Drug Availability: Prescription
Administration Route: Inhalation
Therapeutic Classification: Vasodilator
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Treprostinil
Dosage Form(s): Inhalation solution, powder
What Is Tyvaso Used For?
The Food and Drug Administration (FDA) approved Tyvaso to improve symptoms of high blood pressure in the arteries that carry blood to the lungs. This condition is known as pulmonary arterial hypertension.
How to Take Tyvaso
You should always follow directions given to you by your healthcare provider on how to take your medication.
Tyvaso comes as a solution intended to be inhaled by mouth that requires a device to deliver the medication, known as the Tyvaso Inhalation System. Make sure you get rid of any drug left in the chamber after your last dose, so it is ready for the next day.
It also comes as an inhalant powder used in a dry powder inhaler (DPI) under the brand name Tyvaso DPI. Your healthcare provider will train you on how to use the inhaler.
Unless instructed by your healthcare provider, do not mix other drugs in the nebulizer (inhaler). If this drug accidentally gets in the eyes or on the skin, rinse with water immediately.
Storage
Tyvaso is supplied as four individual vials packaged in a foil pouch.
Store Tyvaso according to the following guidelines:
- Keep it in a cool, dry place at room temperature (68 F to 77 F).
- Do not store it in the bathroom or your refrigerator, and do not freeze it.
- Once the foil pouch is opened, use the vials that contain Tyvaso within seven days.
- Tyvaso is a light-sensitive medication, meaning exposure to light can affect how the drug works and how long the medication is good. Due to this reason, unopened vials should be stored in the original foil pouch.
- When a vial of Tyvaso is opened and transferred to your medicine cup, the solution should remain in the Tyvaso Inhalation System for no more than 24 hours. Any remaining solution should be discarded by the end of the day.
Tyvaso DPI inhalation powder comes in cartridges contained in blister strips. Store them according to the following guidelines:
- Sealed blister strips: Store in the refrigerator to keep them until their expiration date. If you store them at room temperature, you must use them within five weeks.
- Opened blister strips: Don't put an open blister card or strip back into the refrigerator after opening it or storing it at room temperature. Use opened strips within three days.
You can store the Tyvaso DPI inhaler in the refrigerator. However, leave it at room temperature for 10 minutes before using it. You can use the inhaler for up to seven days from its first use. After seven days, discard the inhaler and replace it with a new one.
Keep all your medications out of reach of children and pets.
Tyvaso is only available through a specialty pharmacy. When running low on the medication, it is important to contact your pharmacy before you run out to ensure you don't miss a dose of your medication.
Off-Label Uses
There are currently no off-label uses for Tyvaso. It is important to make sure you are taking Tyvaso only as it is intended, as instructed by your healthcare provider.
How Long Does Tyvaso Take to Work?
Tyvaso takes about 10 minutes to reach its maximum level in your body. Tyvaso is typically taken four times a day, spaced four hours apart, with each dose increasing how much of the drug is in your body. Contact your healthcare provider if it has been a while since you started treatment and you are not noticing any improvements.
What Are the Side Effects of Tyvaso?
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 pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
The following are the most common side effects that have been observed with Tyvaso:
Severe Side Effects
Notify your healthcare provider right away 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:
- Swelling under the skin (angioedema)
- Symptomatic hypotension (low blood pressure), with symptoms including lightheadedness or dizziness and syncope
- Bronchospasm (narrowing of the airways), which can cause difficulty breathing and may be more likely in people with a history of a hyperreactive airway
Long-Term Side Effects
Tyvaso does not have any documented side effects that have occurred after it has been stopped.
Report Side Effects
Tyvaso 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 healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Dosage: How Much Tyvaso Should I Take?
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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.
-
For pulmonary arterial hypertension and pulmonary hypertension with interstitial lung disease:
-
For inhalation dosage form (powder):
- Adults—At first, 16 micrograms (mcg) per treatment session at least 4 hours apart, 4 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 64 mcg per treatment session, 4 times a day.
- Children—Use and dose must be determined by your doctor.
-
For inhalation dosage form (solution):
- Adults—At first, 18 micrograms (mcg) or three breaths, per treatment session at least 4 hours apart, 4 times a day. Each treatment session will take 2 to 3 minutes. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 12 breaths per treatment session, 4 times a day.
- Children—Use and dose must be determined by your doctor.
-
For inhalation dosage form (powder):
Modifications
The following factors can sometimes affect how medications are taken. Here's how they impact treatment with Tyvaso.
Pregnancy
There is currently limited information on Tyvaso and how it may affect the fetus if used during pregnancy. However, pulmonary hypertension is linked to increased risks for the pregnant individual and the fetus. Before starting treatment, let your healthcare provider know if you are pregnant or planning to become pregnant.
Breastfeeding
There is no information on the presence of Tyvaso in breast milk, its effects on the breastfed infant, or its effects on milk production. Talk to your healthcare provider with any questions or concerns.
Children
The safety and efficacy of Tyvaso in children under 18 have not been established.
Advanced Age
The safety and efficacy of Tyvaso observed in older adults (65 and older) were similar to younger adults. Caution should still be exercised due to an increased likelihood of liver or kidney damage in older people and possible interactions with other medications.
Missed Dose
If you miss a dose of Tyvaso, take it as soon as you remember. Therapy should be resumed as soon as possible at the usual dose. Do not take an increased dose to account for the missed dose.
Overdose: What Happens If I Take Too Much Tyvaso?
If you overdose on Tyvaso, you may experience the following:
- Flushing
- Headache
- Low blood pressure
- Nausea or vomiting
- Diarrhea
Immediately seek medical advice if you think you've overdosed on your medication. You may receive general supportive care until the symptoms of the overdose resolve.
What Happens If I Overdose on Tyvaso?
If you think you or someone else may have overdosed on Tyvaso, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Tyvaso, call 911 immediately.
Precautions
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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
It is very important that your doctor check your blood pressure regularly while you are taking this medicine. You may also need to monitor your blood pressure at home. If you notice any changes to your recommended blood pressure, call your doctor right away.
This medicine may increase the risk of bleeding. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
This medicine may make you dizzy, lightheaded, or faint. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Standing up slowly from a sitting or lying position can help.
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. Your doctor may adjust the doses of all the medicines you are taking or monitor you carefully for side effects.
What Are Reasons I Shouldn’t Take Tyvaso?
It is not recommended to take Tyvaso if you have severe liver damage. However, this recommendation is based on the oral administration of treprostinil. There is not enough data on the use of inhaled treprostinil in liver impairment. Therefore, caution should still be exercised.
If you have mild to moderate liver damage, it is difficult to eliminate the medication from your body, so special care must be taken when your dose is increased.
You should also not take this medication if you develop a severe allergic reaction when taking this medication.
What Other Medications Interact With Tyvaso?
Because certain medications can affect the way treprostinil works, it is essential to tell your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.
Tyvaso is further broken down in the body by specific proteins made by the liver called CYP2C8 enzymes. Any medication that decreases the production of these proteins can increase the amount of Tyvaso in your body. These include:
- Lopid (gemfibrozil)
- Nardil (phenelzine)
Ask your healthcare provider or pharmacist if you are unsure whether you are taking a medication that inhibits CYP2C8.
Tyvaso can enhance the effects of blood pressure-lowering medications. Medications that are used to decrease blood pressure include:
This is not a complete list of medications that may interact with Tyvaso. Talk with your pharmacist or healthcare provider for more detailed information about potential interactions.
What Medications Are Similar?
Tyvaso belongs to a class of medications known as prostacyclin analogues. The following medications are also part of this drug class:
- Flolan (epoprostenol)
- Ventavis (iloprost)
The following are other drugs that the FDA has also approved to treat high blood pressure in the arteries of the lungs:
This is a list of drugs commonly used to treat pulmonary hypertension. It is NOT a list of drugs recommended to take with Tyvaso. Talk to your pharmacist or healthcare provider if you have any questions.
How Can I Stay Healthy While Taking Tyvaso?
To stay healthy while taking Tyvaso, it is important to take this medication every day as directed by your healthcare provider. Maintaining a healthy lifestyle is also essential and may include improving your diet or exercising regularly.
With your condition, exercise may be challenging to achieve at first. Still, you should try to remain active. Pulmonary hypertension is a chronic disease that worsens over time. Recent literature has shown that light exercises under expert supervision have helped improve quality of life. While there are benefits associated with physical activity, it is also important not to overdo it. You should only do light exercise if you can tolerate it and with your healthcare provider's approval.
Talk to your healthcare provider to help you develop an exercise regimen specific to you.
Medical Disclaimer
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.
I would like to recognize and thank Cody Ryan Thomas for contributing to this article.
