You’ve been diagnosed with pulmonary hypertension (PH)… now what? Although there is currently no cure for pulmonary hypertension, there are treatment options available and more are on the horizon. Treatments include what health care providers call conventional medical therapies as well as oral, inhaled, subcutaneous (into the skin), and intravenous (into the vein) options. Depending on the severity of PH, heart or lung transplant may also be an option.
Remember that each patient is different. It is essential that you talk to your own doctor about what treatment options are best for you.
Fact Sheets Issued by PHA’s Scientific Leadership Council
Conventional Medical Therapies
- Calcium Channel Blockers – Help decrease blood pressure (Only appropriate for a small minority of patients demonstrating a favorable response to vasodilator testing at the time of heart catheterization.)
- Digoxin – Assists the pumping of the heart
- Diuretics – Rids excess fluid that puts pressure on the heart
- Oxygen – Inhaled by patients via a nasal cannula or face mask. Learn more about inhaled oxygen.
- Warfarin (e.g. Coumadin®) – “Thins” blood and prevents it from clotting
Oral Treatment Options
Endothelin Receptor Antagonists (ERAs) help prevent blood vessels from narrowing.
- Ambrisentan (Letairis®)
- Bosentan (Tracleer®)
- Bosentan (Tracleer®) for Pediatric Use
- Macitentan (Opsumit®)
Phosphodiesterase Inhibitors (PDE 5 Inhibitors) allow the lungs to produce more of its own natural vasodilators.
Prostacyclin Analogue allows the blood vessels in the lungs relax
Selective IP Receptor Agonist targets and activates a prostacyclin receptor which helps the blood vessels in the lungs relax.
Soluble Guanylate Cyclase (sGC) Stimulators increase the interaction of the sGC enzyme with another chemical (nitric oxide) to help the blood vessels in the lungs relax.
Inhaled Treatment Options
Inhaled Treatment Options, including prostacyclins, relieve shortness of breath.
Subcutaneous Treatment Options
Subcutaneous Treatment Options are delivered through a portable infusion pump to open up the blood vessels and ease the symptoms of PH.
Intravenous Treatment Options
Intravenous Treatment Options open up the blood vessels and help ease symptoms of PH, including chest pain and shortness of breath.
- Intravenous Treprostinil (Remodulin®)
- Epoprostenol (Flolan®)
- Room Temperature Stable Epoprostenol (Veletri®)
Over-the-Counter Medications and Supplements
While they don’t require a prescription, over-the-counter (OTC) medications and herbal supplements may be harmful and should be used cautiously if you have PH. Certain ingredients in these drugs may have a direct effect on the heart and lungs or may interact with medications commonly prescribed for PH. As with prescription drugs, talk to your PH doctor before taking anything new. Here are a few important interactions you should know about.
- Avoid decongestants and medications that contain stimulants (including cold, flu, sinus, allergy, and headache medications). These medications cause vasoconstriction (narrowing of blood vessels) and may worsen PH and increase blood pressure and heart rate. They may also cause palpitations and irregular heart rhythms. Medications that contain antihistamines (e.g., diphenhydramine, Benadryl, Claritin) may be used to treat cold symptoms, allergies and hay fever, provided that they do not also contain decongestants.
- Aspirin, Advil, Motrin, Naprosyn, Aleve and Tylenol should be used with caution in patients taking warfarin (Coumadin). Talk to your PH specialist before taking Non-Steroidal Anti Inflammatory (NSAID) medications such as Advil, Motrin, Naprosyn and Aleve. NSAIDs may cause swelling and fluid retention.
- Herbal therapies should be viewed as drugs, not simply as “natural supplements.” Discuss these drugs with your PH specialist prior to taking anything new. PHA’s Scientific Leadership Council has issued a consensus statement on some of the commonly used agents that may lead to complications when taken in combination with select PH medications, including ephedra (ma huang), dong quai, St. John’s Wort, ginseng, ginkgo, danshen, papaya extract, kava, Echinacea, valerian, vitamins A, E, and K and others.
Any ingredient contraindicated in patients with high blood pressure is, as a general rule, contraindicated in patients with PH. If you’re uncertain about the contents of a specific medication, ask a pharmacist for assistance.
Research and Clinical Trials
Read about participating in research and clinical trials
Stem Cell Therapy
Read about stem cell therapy and PH
Visit our lung transplantation section