Can you imagine the blood vessels that carry blood from our heart to our lungs gradually narrowing, causing the blood pressure to increase dramatically? It's like squeezing a water pipe and the speed of the water increases. This is what we call ' Pulmonary Arterial Hypertension' or 'PAH' in medicine. This is a condition that is a little different from normal high blood pressure and requires special attention. This can cause symptoms like shortness of breath, chest pain, and extreme fatigue. So today we are going to talk about a special drug used to treat this condition, which is the Treprostinil injection.
What kind of medicine is Treprostinil?
Simply put, Treprostinil (brand name: Remodulin) is a drug that is given to people with the pulmonary arterial hypertension (PAH) that I mentioned earlier. This drug works by widening the narrowed blood vessels a little, making it easier for blood to flow. This reduces the workload on the heart and helps control symptoms. It also makes it easier to carry out daily activities. This is a very important drug that helps improve the quality of life.
Your doctor may also prescribe this medication for other conditions, so if you have any questions about this, be sure to ask your doctor.
Things to tell your doctor before starting this medication
Before starting this medication, it is very important to give your doctor a complete description of your health condition. Be sure to mention the following in particular:
- Kidney disease: If you have any kidney-related condition.
- Liver disease: If there is any problem with liver function.
- Allergies: Be sure to tell your doctor if you have had an allergic reaction to Treprostinil, Epoprostenol, or any other medicine, food, or dye.
- Pregnancy: If you are pregnant, trying to get pregnant, or breastfeeding, you should talk to your doctor before starting this medication.
How should I use this medicine?
This is not like a pill or capsule that we usually take. The Treprostinil injection is given into your body through a small pump that is constantly running (continuous infusion) . The medicine goes into your body through a thin tube, called a catheter, connected to this pump. This can be done in two ways:
1. Subcutaneous: The catheter is inserted under the skin and the medication is given.
2. Intravenous: The medication is given by inserting a catheter directly into a blood vessel (vein).
You will be given very thorough training at the hospital on how to use this, how to prepare the pump, and how to insert the catheter. It is very important to follow the instructions given by the doctor and nursing staff exactly .
Very important: Do not stop taking this medication for any reason without consulting your medical team. Stopping it suddenly could make your condition worse.
What do you do with used needles and syringes?
Never throw used needles and syringes in the trash. They should be placed in a special container (sharps container) provided. If you don't have one, ask your doctor or hospital for one.
Should this medicine be given to children?
Children may require special care when giving this medicine, so it is essential to discuss this with a pediatrician for advice.
What if I take too much medicine?
If you think you have taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other drugs that may interact with this medicine (Drug Interactions)
Other medications you are taking may interact with Treprostinil, so tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements).
| Drug type | Things to watch out for |
|---|---|
| Some medications for high blood pressure | When these are combined with Treprostinil, blood pressure may drop too low. |
| Anticoagulant | Examples: Medicines like Warfarin, Enoxaparin, Dabigatran, Apixaban. These can increase the risk of bleeding. |
| Diuretics | May cause low blood pressure. |
| Other medications | Drugs such as Gemfibrozil and Rifampin may affect the effectiveness of this medicine. |
Things to keep in mind when taking medication
- Regular check-ups: Stay in touch with your doctor regularly to monitor the progress of your condition. Go to clinics regularly.
- Skin around the catheter: Check the skin around the catheter regularly. If there is unusual redness, pain, swelling, or pus-like discharge, notify your healthcare team immediately. This could be a sign of infection.
- If your condition gets worse: Sometimes your condition may get worse even after taking this medicine. If you feel this way, such as if you have difficulty breathing or chest pain, call your doctor right away. Your dose may need to be changed.
Side effects that may occur due to medication
Like any medicine, Treprostinil can cause side effects. Some of these are serious, while others are common.
| Classification of side effects | |
|---|---|
| Side effects that should be reported to your doctor immediately | |
| Allergic reactions such as skin rashes, itching, hives | Swelling of the face, lips, or tongue |
| Difficulty breathing | Chest pain |
| Abnormally fast, pounding, or irregular heartbeat | Nausea, dizziness, and falls |
| Fever or feeling cold | Bruising, pain, or swelling at the injection site |
| Pain, numbness, or loss of feeling in the hands and feet | Unusual weakness or fatigue |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Bone or jaw pain | Diarrhea |
| Flushing | Headache |
| Nausea, vomiting | |
How to store medicine?
To maintain the quality of the medicine, it is very important to store it properly.
- Keep away from children and pets.
- Unopened vials: Store at a temperature between 15 and 25 degrees Celsius.
- After opening a vial: After the first dose of medicine is taken, the vial should be used within 30 days.
- Expired medicine: Do not use for any reason after the expiration date.
- Medicines in the pump:
- If given subcutaneously: The medicine in one syringe can be used for up to 72 hours. After 72 hours, discard the remaining medicine.
- If given intravenously: The medicine in one syringe can be used for up to 48 hours. Discard the remaining medicine after 48 hours.
Take-Home Message
- Treprostinil is a very important medication for the control of pulmonary arterial hypertension (PAH). It should be used only as directed by your doctor.
- Before starting this medication, tell your doctor about all your medical conditions and all other medications you are taking.
- Do not stop taking your medication without medical advice for any reason. It can be very dangerous.
- Always be on the lookout for serious side effects such as redness, pain, and swelling at the injection site, as well as chest pain and difficulty breathing. If you notice any of these, inform your doctor immediately.
- It is very important to store medication properly and dispose of used needles safely.
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