Orenitram works by relaxing blood vessels in the lungs, which decreases blood pressure in the lungs and improves heart function. By improving heart function, the medication can increase exercise ability and delay disease progression.  

Orenitram is taken two or three times a day, depending your prescription. Don’t take two doses at the same time. Doses typically start at 0.125 mg two or three times a day. It’s increased by 0.125mg every two to four weeks if there are no side effects. There is no known upper dose limit.

This medication is available in five strengths:

• White 0.125 mg tablet
• Green 0.25 mg tablet
• Yellow 1 mg tablet
• Pink 2.5 mg tablet
• Red 5 mg tablet

Always take this medication with food. Swallow tablets whole. Do not crush, split or chew.

If you miss a dose, take the missed dose with food as soon as possible unless it’s close to the time for the next dose. If it’s close to the time for the next dose, skip the missed dose and go back to the usual time. Don’t take two doses at the same time. Don’t take extra doses.

Oral treprostinil is a limited-distribution medication, which means you can’t fill your prescription at a local pharmacy. A doctor or advanced practice provider who has experience prescribing PH medications must prescribe this medication. You’ll need approval from your insurance company before starting therapy. A specialty pharmacy company determined by your insurance company will ship the medication to you.

The most common side effects of this medication are:

• Headache
• Pain in jaw
• Diarrhea
• Pain in arms or legs
• Nausea
• Abdominal discomfort
• Flushing

You might have minor side effects, such as mild flushing or loose stools, all the time.

The outside of the pill that contains the medicine doesn’t dissolve in your stomach. You might see small shell in your feces.

If you’re dizzy or pass out, your blood pressure might be low. This requires urgent medical attention.

Allergic reactions to this medication are possible, but unlikely. If you think you might be allergic, contact your health care provider immediately.

Certain patient populations must take precautions while taking oral treprostinil, while others should avoid it. Learn about who can and who shouldn’t take this medication:

Pregnant and breastfeeding patients: Limited data exists on the effects of oral treprostinil in pregnant women. Research studies have shown harmful effects on animal fetuses. There are no adequate or well-controlled human studies.

It’s unknown whether treprostinil is excreted in human milk or absorbed after ingestion. Because many drugs are excreted in human milk, talk to your doctor about the best way to feed your baby while taking this medication.

Children and teens: Safety and efficacy for pediatric patients hasn’t been established.

People with liver disease: Use oral treprostinil with caution if you have mild liver impairment. Avoid taking this if you have moderate liver impairment. Don’t use if you have severe liver disease.

There is increased exposure of treprostinil throughout the body because liver can’t fully clear the medication. Dialysis doesn’t remove oral treprostinil.

People with diverticulitis: Ask your doctor about taking this medication if you know you have diverticulosis.

No medications are prohibited with oral treprostinil, but some this medication can interact with some drugs:

When oral treprostinil is taken with certain enzyme inhibitors, treprostinil levels can increase throughout the body. Your doctor may reduce your oral treprostinil dosage if you take CYP2C8 enzyme inhibitors (such as gemfibrozil), which interact with liver enzymes that can change drug levels.

Oral treprostinil can be taken with anticoagulants, such as Coumadin. However, oral treprostinil prevents platelets from clumping together to form clots, so taking anticoagulants might increase your risk of bleeding.

Don’t take oral treprostinil with alcohol, which can cause treprostinil to release from the tablet faster than intended. That could cause more side effects.

Discuss all medications with your health care team at every visit, including over-the-counter drugs and herbal supplements.