Indications for: TYVASO
To improve exercise ability in patients with: pulmonary arterial hypertension (WHO Group 1) with NYHA Class III symptoms; and pulmonary hypertension associated with interstitial lung disease (WHO Group 3).
Give 4 separate treatment sessions each day approximately 4hrs apart, during waking hours. ≥18yrs: Initially 3 breaths (18mcg) per treatment session; if not tolerated, reduce to 1–2 breaths, and then subsequently increase to 3 breaths as tolerated. Maintenance: may increase by an additional 3 breaths at 1–2 week intervals, if tolerated, to target doses of 9–12 breaths per session.
<18yrs: not established.
Risk of symptomatic hypotension in those with low systemic arterial pressure. Hepatic insufficiency; titrate slowly. Risk of bleeding. Asthma, COPD, or other bronchial hyperreactivity. For Tyvaso Inhalation Solution: avoid contact with eyes and skin, oral ingestion. Elderly. Pregnancy. Nursing mothers.
Do not use with other medications. May be potentiated by CYP2C8 inhibitor (eg, gemfibrozil). May be antagonized by CYP2C8 inducer (eg, rifampin).
Cough, headache, nausea, diarrhea, dizziness, flushing, throat irritation, pharyngolaryngeal pain, syncope, dyspnea; symptomatic hypotension, bleeding, bronchospasm.
Renal (79%), fecal (13%). Half-life: ~4 hours (Tyvaso Inhalation Solution); 27–50 minutes (Tyvaso DPI).
Generic Drug Availability:
Ampules (2.9mL)—4; Starter Kit—1 (28 ampules with inhalation system); Refill Kit—1 (28 ampules with accessories); DPI Titration Kit—1 (112 cartridges [16mcg] + 84 cartridges [32mcg] w. 5 inhalers); (112 cartridges [16mcg] + 112 cartridges [32mcg] + 28 cartridges [48mcg] w. 5 inhalers); DPI Maintenance Kit—1 (112 cartridges [16mcg, 32mcg, 48mcg, or 64mcg] w. 5 inhalers); (112 cartridges [32mcg] + 112 cartridges [48mcg] w. 5 inhalers)