Tyvaso DPI treprostinil 80 ug Inhalant
🆔 Identity & classification
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🏷️ RxNorm drug class
This medicine belongs to the Prostacycline Vasodilator class.
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🏭 Manufacturer & labeler
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🩺 Clinical
Treprostinil oral inhalation is used to treat certain kinds of pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Treprostinil oral inhalation is also used to treat pulmonary hypertension associated with interstitial lung disease (PH-ILD; high blood pressure in the lungs resulting from a lung disease that involves inflammation and scarring of the lungs). Treprostinil may improve the ability to exercise and slow the worsening of symptoms in patients with PAH and PH-ILD. Treprostinil is in...
Read the full MedlinePlus article ↗- Treprostinil mimics a natural substance your body makes to keep blood vessel walls relaxed. In pulmonary arterial hypertension (PAH) — and in some lung-disease-related forms of hig...
- What exactly is treprostinil and why did my doctor prescribe it?
- The inhaled products are all used multiple times per day, spaced out across your waking hours. Tyvaso and Tyvaso DPI are typically used 4 times a day, roughly 4 hours apart. Yutrep...
- I'm on the inhaled version — how often do I need to use it each day?
Patient education
Supplement & herbal interactions
Some supplements/herbs that may interact with Treprostinil — tap one for details:
Treprostinil (Inh) may be associated with lower levels of 1 nutrient — worth a chat with your pharmacist, not a cause for alarm.
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🧪 Inactive Ingredients / Excipients
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UNII XB09609XSL
A synthetic compound used as a glidant and anti-caking agent. It reduces friction between particles and prevents clumping in powdered formulations, helping the medicine flow smoothly during manufacturing and packaging.
1 inactive ingredient listed in the exact product block matched to this NDC.
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ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
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💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per each | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data. | |
| Medicare drug plans payPart D · Q2 2026 | $100.95 | $1,615.24 / 16 inhalants |
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🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Tyvaso DPI 80 ug 66302-0680-03 | United | 1 kit | — | — | FDA listed | — |
| Tyvaso DPI 80 ugthis 66302-0780-04 | United | 1 kit | — | — | FDA listed | — |
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⏳ Availability & generic status
We did not find an FDA-approved generic match for this exact strength, form and route. Patent/protection dates below may affect future generic timing.
Why the date isn’t exact: Generic timing can change because patents may be challenged, settled, licensed, added, removed, or worked around with a narrower label — and FDA approval does not always mean a pharmacy can get the generic today.
🛈 What do these terms mean?
- Patent
- Legal protection listed in the Orange Book that may delay generic approval or launch. Issued by the U.S. Patent & Trademark Office.
- Substance patent
- Covers the active drug molecule itself — the hardest to design around. A generic generally can’t launch until it expires.
- Formulation (product) patent
- Covers a specific formulation or dosage form. A generic can sometimes work around it with a different formulation.
- Method-of-use patent
- A patent covering one specific approved use of the drug — not necessarily the whole molecule. A generic can sometimes launch with a “skinny label” that carves out the protected use and keeps the others.
- Skinny label
- A generic label that omits a still-patented use when the FDA allows it — letting a generic reach the market for the unprotected uses.
- Exclusivity
- FDA-granted marketing protection, separate from patents — e.g. 5-yr new chemical entity, 7-yr orphan drug, or a +6-month pediatric extension.
- Paragraph IV
- A generic applicant’s formal challenge to a listed patent. It can potentially lead to earlier generic entry, but often involves litigation or a settlement.
- RLD / RS
- Reference Listed Drug — the brand product the FDA uses as the reference for generic applications. Reference Standard — the product the FDA expects generics to compare against in bioequivalence testing.
- TE / AB rating
- FDA therapeutic-equivalence rating. An AB rating generally means the FDA considers a generic therapeutically equivalent to — and substitutable for — the brand.
- LOE (loss of exclusivity)
- The latest patent or exclusivity currently listed — the loss-of-exclusivity / latest-listed-protection date shown on this page. Paragraph-IV challenges and settlements can move the real date earlier; FDA approval and a manufacturer’s decision to market can move it later.
Built from the FDA Orange Book. The bars above are scaled to each protection’s expiry; the red LOE marker is the last one to lapse.
| Patent | Type | Use code | Expires |
|---|---|---|---|
| US 11357782 ↗ | Method of use | U-1849 | May 14, 2027 |
| US 11357782 ↗ | Method of use | U-1849 | May 14, 2027 |
| US 11357782 ↗ | Method of use | U-1849 | May 14, 2027 |
| US 11357782 ↗ | Method of use | U-1849 | May 14, 2027 |
| US 11357782 ↗ | Method of use | U-1849 | May 14, 2027 |
| US 11826327 ↗ | Method of use | U-3749 | Feb 3, 2042 |
| US 11826327 ↗ | Method of use | U-3749 | Feb 3, 2042 |
| US 11826327 ↗ | Method of use | U-3749 | Feb 3, 2042 |
| US 11826327 ↗ | Method of use | U-3749 | Feb 3, 2042 |
| US 11826327 ↗ | Method of use | U-3749 | Feb 3, 2042 |
| US 9593066 ↗ | Drug substance | — | Dec 15, 2028 |
| US 10421729 ↗ | Drug product | — | Apr 1, 2035 |
| US 10421729 ↗ | Drug product | — | Apr 1, 2035 |
| US 11723887 ↗ | Drug substance | — | Dec 15, 2028 |
| US 10421729 ↗ | Drug product | — | Apr 1, 2035 |
| US 9593066 ↗ | Drug substance | — | Dec 15, 2028 |
| US 9593066 ↗ | Drug substance | — | Dec 15, 2028 |
| US 11723887 ↗ | Drug substance | — | Dec 15, 2028 |
| US 11723887 ↗ | Drug substance | — | Dec 15, 2028 |
| US 11723887 ↗ | Drug substance | — | Dec 15, 2028 |
| US 10772883 ↗ | Drug product | — | Jun 11, 2030 |
| US 10772883 ↗ | Drug product | — | Jun 11, 2030 |
| US 10772883 ↗ | Drug product | — | Jun 11, 2030 |
| US 9593066 ↗ | Drug substance | — | Dec 15, 2028 |
| US 10772883 ↗ | Drug product | — | Jun 11, 2030 |
| US 10421729 ↗ | Drug product | — | Apr 1, 2035 |
| US 10421729 ↗ | Drug product | — | Apr 1, 2035 |
| US 10772883 ↗ | Drug product | — | Jun 11, 2030 |
| US 9593066 ↗ | Drug substance | — | Dec 15, 2028 |
| US 11723887 ↗ | Drug substance | — | Dec 15, 2028 |
Is there a generic version of TYVASO DPI 80 MCG CARTRIDGE?
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📊 Medicare Part D spend CMS · PART D · 2026 (Q1)
🔬 Reported adverse events (FAERS)
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📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 66302-0780-04 You're viewing this | 1 BLISTER PACK in 1 KIT (66302-780-04) / 4 BLISTER PACK in 1 BLISTER PACK / 4 INHALANT in 1 BLISTER PACK | 2024-10-24 | Active |
🧭 About this NDC listing & data coverage
Kit / multi-component package
This NDC identifies a kit — a package containing more than one component. Structured data (pricing, ingredients, equivalents) is often reported per component rather than for the kit NDC itself, which can make this page look thinner than the components' own pages.
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| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | ✓ Available |
| Package photos | ✓ Available |
| Inactive ingredients (structured) | ✓ Available |
| NADAC pharmacy acquisition price (CMS) | — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey. |
| Orange Book / therapeutic-equivalence data | ✓ Available |
| HCPCS J-code billing crosswalk | — Not published for this NDC Most self-administered / retail products have no J-code — that is normal. |
| Medicaid utilization (CMS SDUD) | — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold. |
Questions about this listing
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📄 Full prescribing information FDA SPL
🎯 Indications and Usage ▾
1 INDICATIONS AND USAGE Tyvaso DPI is a prostacyclin mimetic indicated for the treatment of: Pulmonary arterial hypertension (PAH; WHO Group 1) to improve exercise ability. Studies with Tyvaso establishing effectiveness predominately included patients with NYHA Functional Class III symptoms and etiologies of idiopathic or heritable PAH (56%) or PAH associated with connective tissue diseases (33%). ( 1.1 ) Pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) to improve exercise ability.
The study with Tyvaso establishing effectiveness predominately included patients with etiologies of idiopathic interstitial pneumonia (IIP) (45%) inclusive of idiopathic pulmonary fibrosis (IPF), combined pulmonary fibrosis and emphysema (CPFE) (25%), and WHO Group 3 connective tissue disease (22%). ( 1.2 )
1.1Pulmonary Arterial Hypertension Tyvaso DPI is indicated for the treatment of pulmonary arterial hypertension (PAH; WHO Group 1) to improve exercise ability. Studies with Tyvaso establishing effectiveness predominately included patients with NYHA Functional Class III symptoms and etiologies of idiopathic or heritable PAH (56%) or PAH associated with connective tissue diseases (33%). The effects diminish over the minimum recommended dosing interval of 4 hours; treatment timing can be adjusted for planned activities.
While there are long-term data on use of treprostinil by other routes of administration, nearly all clinical experience with inhaled treprostinil has been on a background of an endothelin receptor antagonist (ERA) and/or a phosphodiesterase type 5 (PDE-5) inhibitor. The controlled clinical experience with Tyvaso was limited to 12 weeks in duration [see Clinical Studies (14) ] .
1.2Pulmonary Hypertension Associated with ILD Tyvaso DPI is indicated for the treatment of pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) to improve exercise ability. The study with Tyvaso establishing effectiveness predominately included patients with etiologies of idiopathic interstitial pneumonia (IIP) (45%) inclusive of idiopathic pulmonary fibrosis (IPF), combined pulmonary fibrosis and emphysema (CPFE) (25%), and WHO Group 3 connective tissue disease (22%) [see Clinical Studies (14.3) ] .
⏱️ Dosage and Administration ▾
2 DOSAGE AND ADMINISTRATION Use only with the Tyvaso DPI Inhaler. ( 2.1 ) Administer using a single inhalation per cartridge. ( 2.1 ) Administer in 4 separate treatment sessions each day approximately 4 hours apart, during waking hours.
( 2.1 ) Initial dosage: one 16 mcg cartridge per treatment session. ( 2.2 ) Dosage should be increased by an additional 16 mcg per treatment session at approximately 1- to 2-week intervals, if tolerated. ( 2.2 ) Titrate to target maintenance doses of 48 mcg to 64 mcg per treatment session, 4 times daily.
( 2.2 )
2.1Administration Use Tyvaso DPI only with the Tyvaso DPI Inhaler. Tyvaso DPI is administered using a single inhalation per cartridge. Administer Tyvaso DPI in 4 separate, equally spaced treatment sessions per day, during waking hours.
The treatment sessions should be approximately 4 hours apart. If the prescribed dose is higher than 80 mcg per treatment session, more than 1 cartridge will be needed per session. Patients should follow the instructions for use for operation and care of the Tyvaso DPI Inhaler.
Do not use the Tyvaso DPI Inhaler with other medications. Between each of the 4 daily treatment sessions, store the Tyvaso DPI Inhaler with the mouthpiece attached and empty. Wipe the outside of the inhaler with a clean, dry cloth only, if needed.
Do not rinse or wash the Tyvaso DPI Inhaler; always keep the inhaler dry. After 7 days of use, throw away the used Tyvaso DPI Inhaler into regular household trash.
2.2Usual Dosage in Adults Initial Dosage: Tyvaso DPI therapy should begin with one 16 mcg cartridge per treatment session, 4 times daily. Maintenance Dosage: Increase dosage by an additional 16 mcg per treatment session at approximately 1- to 2-week intervals. The target maintenance dosage is usually 48 mcg to 64 mcg per session.
If adverse effects preclude titration, continue Tyvaso DPI at the highest tolerated dose. If a scheduled treatment session is missed, resume therapy as soon as possible at the usual dose. Dosage for Transition from Tyvaso ® (treprostinil) Inhalation Solution: The following regimens of Tyvaso DPI and Tyvaso give similar exposure: Tyvaso DPI Cartridge Strength Tyvaso Number of Breaths 16 mcg ≤5 (≤30 mcg) 32 mcg 6 to 7 (36 to 42 mcg) 48 mcg 8 to 10 (48 to 60 mcg) 64 mcg 11 to 13 (66 to 78 mcg) 80 mcg 14 to 15 (84 to 90 mcg)
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS AND STRENGTHS Inhalation powder: Single-dose plastic cartridges containing 16 mcg, 32 mcg, 48 mcg, 64 mcg, or 80 mcg of treprostinil as a dry powder formulation. Inhalation powder: Single-dose plastic cartridges containing 16 mcg, 32 mcg, 48 mcg, 64 mcg, or 80 mcg of treprostinil as a dry powder formulation. ( 3 )
⛔ Contraindications ▾
4 CONTRAINDICATIONS None. None. ( 4 )
⚠️ Warnings and Cautions ▾
5 WARNINGS AND PRECAUTIONS Tyvaso DPI may cause symptomatic hypotension. ( 5.1 ) Tyvaso DPI inhibits platelet aggregation and increases the risk of bleeding. ( 5.2 ) Tyvaso DPI dosage adjustments may be necessary if inhibitors or inducers of CYP2C8 are added or withdrawn. ( 5.3 , 7.3 ) May cause bronchospasm: Patients with a history of hyperreactive airway disease may be more sensitive. ( 5.4 )
5.1Risk of Symptomatic Hypotension Treprostinil is a pulmonary and systemic vasodilator. In patients with low systemic arterial pressure, treatment with Tyvaso DPI may produce symptomatic hypotension.
5.2Risk of Bleeding Tyvaso DPI inhibits platelet aggregation and increases the risk of bleeding.
5.3Effect of Other Drugs on Treprostinil Co-administration of a cytochrome P450 (CYP) 2C8 enzyme inhibitor (e.g., gemfibrozil) may increase exposure (both C max and AUC) to treprostinil. Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. Increased exposure is likely to increase adverse events associated with treprostinil administration, whereas decreased exposure is likely to reduce clinical effectiveness [see Drug Interactions (7.3) and Clinical Pharmacology (12.3) ] .
5.4Bronchospasm Like other inhaled prostaglandins, Tyvaso DPI may cause acute bronchospasm. Patients with asthma or chronic obstructive pulmonary disease (COPD), or other bronchial hyperreactivity, are at increased risk for bronchospasm. Ensure that such patients are treated optimally for reactive airway disease prior to and during treatment with Tyvaso DPI.
🤒 Adverse Reactions ▾
6 ADVERSE REACTIONS The following potential adverse reactions are described in Warnings and Precautions (5): - Decrease in systemic blood pressure [see Warnings and Precautions (5.1) ] . - Bleeding [see Warnings and Precautions (5.2) ] . Most common adverse reactions (≥4%) are cough, headache, throat irritation/pharyngolaryngeal pain, nausea, flushing, dyspnea, and syncope. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact United Therapeutics Corp. at 1-866-458-6479 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
6.1Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Pulmonary Arterial Hypertension Tyvaso DPI In a 3-week, open-label, single-sequence, safety and tolerability study (BREEZE) conducted in 51 patients on stable doses of Tyvaso Inhalation Solution who switched to a corresponding dose of Tyvaso DPI, the most commonly reported adverse events on Tyvaso DPI during the 3-week treatment phase included cough, headache, dyspnea, and nausea.
Patient tolerability, as assessed by incidence of new adverse events following transition to Tyvaso DPI, was consistent with the expected known safety profile of Tyvaso Inhalation Solution. Table 1 lists the adverse events that occurred at a rate of at least 4%. Table 1: Adverse Events in ≥4% of PAH Patients Receiving Tyvaso DPI in BREEZE (Treatment Phase) Adverse Event Tyvaso DPI (n=51) n (%) Cough 18 (35.3) Headache 8 (15.7) Dyspnea 4 (7.8) Nausea 3 (5.9) The safety of Tyvaso DPI was also studied in an extension phase of the study in which 49 patients were dosed for a duration of 43 patient-years.
Fifty-nine percent (59%) of patients achieved a dose of 64 mcg, 4 times daily or higher. The adverse events during this long-term, extension phase were similar to those observed in the 3-week treatment phase. Tyvaso Inhalation Solution In a 12-week, placebo-controlled study (TRIUMPH I) of 235 patients with PAH (WHO Group 1 and nearly all NYHA Functional Class III), the most commonly reported adverse reactions on Tyvaso Inhalation Solution included cough and throat irritation, headache, gastrointestinal effects, muscle, jaw or bone pain, dizziness, flushing, and syncope.
Table 2 lists the adverse reactions that occurred at a rate of at least 4% and were more frequent in patients treated with Tyvaso Inhalation Solution than with placebo. Table 2: Adverse Events in ≥4% of PAH Patients Receiving Tyvaso Inhalation Solution and More Frequent More than 3% greater than placebo than Placebo in TRIUMPH I Adverse Event Treatment n (%) Tyvaso Inhalation Solution n=115 Placebo n=120 Cough 62 (54) 35 (29) Headache 47 (41) 27 (23) Throat Irritation / Pharyngolaryngeal Pain 29 (25) 17 (14) Nausea 22 (19) 13 (11) Flushing 17 (15) 1 (<1) Syncope 7 (6) 1 (<1) Pulmonary Hypertension Associated with ILD In a 16-week, placebo-controlled study (INCREASE) of 326 patients with PH-ILD (WHO Group 3), adverse reactions on Tyvaso Inhalation Solution were similar to the experience in studies of PAH.
🔄 Drug Interactions ▾
7 DRUG INTERACTIONS
7.1Bosentan In a human pharmacokinetic study conducted with bosentan (250 mg/day) and an oral formulation of treprostinil (treprostinil diolamine), no pharmacokinetic interactions between treprostinil and bosentan were observed.
7.2Sildenafil In a human pharmacokinetic study conducted with sildenafil (60 mg/day) and an oral formulation of treprostinil (treprostinil diolamine), no pharmacokinetic interactions between treprostinil and sildenafil were observed.
7.3Effect of Cytochrome P450 Inhibitors and Inducers In vitro studies of human hepatic microsomes showed that treprostinil does not inhibit cytochrome P450 (CYP) isoenzymes CYP1A2, CYP2A6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1, and CYP3A. Additionally, treprostinil does not induce cytochrome P450 isoenzymes CYP1A2, CYP2B6, CYP2C9, CYP2C19, and CYP3A. Human pharmacokinetic studies with an oral formulation of treprostinil (treprostinil diolamine) indicated that co-administration of the cytochrome P450 (CYP) 2C8 enzyme inhibitor, gemfibrozil, increases exposure (both C max and AUC) to treprostinil.
Co-administration of the CYP2C8 enzyme inducer, rifampin, decreases exposure to treprostinil. It is unclear if the safety and efficacy of treprostinil by the inhalation route are altered by inhibitors or inducers of CYP2C8 [see Warnings and Precautions (5.3) ] .
7.4Effect of Other Drugs on Treprostinil Drug interaction studies have been carried out with treprostinil (oral or subcutaneous) co-administered with acetaminophen (4 g/day), warfarin (25 mg/day), and fluconazole (200 mg/day), respectively, in healthy volunteers. These studies did not show a clinically significant effect on the pharmacokinetics of treprostinil. Treprostinil does not affect the pharmacokinetics or pharmacodynamics of warfarin.
The pharmacokinetics of R- and S- warfarin and the international normalized ratio (INR) in healthy subjects given a single 25 mg dose of warfarin were unaffected by continuous subcutaneous infusion of treprostinil at an infusion rate of 10 ng/kg/min.
👥 Use in Specific Populations ▾
8 USE IN SPECIFIC POPULATIONS
8.1Pregnancy Risk Summary Limited case reports of treprostinil use in pregnant women are insufficient to inform a drug-associated risk of adverse developmental outcomes. However, there are risks to the mother and the fetus associated with pulmonary arterial hypertension (see Clinical Considerations ) . In animal studies, no adverse reproductive and developmental effects were seen for treprostinil at ≥8 and ≥134 times the human exposure when based on C max and AUC, respectively, following a single, inhaled 64 mcg dose of treprostinil inhalation powder.
The estimated background risk of major birth defects and miscarriage for the indicated populations is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.
Clinical Considerations Disease-associated maternal and embryo-fetal risk Pulmonary arterial hypertension is associated with an increased risk of maternal and fetal mortality. Data Animal reproduction studies have been conducted with treprostinil via continuous subcutaneous administration and with treprostinil diolamine administered orally. In studies with orally administered treprostinil diolamine, no adverse effect doses for fetal viability/growth, fetal development (teratogenicity), and postnatal development were determined in rats.
In pregnant rats, no evidence of harm to the fetus was observed following oral administration of treprostinil diolamine at the highest dose tested (20 mg/kg/day), which represents about 129 and 1366 times the human exposure, when based on C max and AUC, respectively, following a single, inhaled 64 mcg dose of treprostinil inhalation powder. In pregnant rabbits, external fetal and soft tissue malformations and fetal skeletal malformation occurred. The dose at which no adverse effects were seen (0.5 mg/kg/day) represents about 8 and 134 times the human exposure, when based on C max and AUC, respectively, following a single, inhaled 64 mcg dose of treprostinil inhalation powder.
No treprostinil treatment-related effects on labor and delivery were seen in animal studies. Animal reproduction studies are not always predictive of human response.
8.2Lactation Risk Summary There are no data on the presence of treprostinil in human milk, the effects on the breastfed infant, or the effects on milk production.
8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established. Clinical studies of inhaled treprostinil did not include patients younger than 18 years to determine whether they respond differently from older patients.
8.5Geriatric Use Across clinical studies used to establish the effectiveness of Tyvaso Inhalation Solution in patients with PAH and PH-ILD, 268 (47.8%) patients aged 65 years and over were enrolled. The treatment effects and safety profile observed in geriatric patients were similar to younger patients. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of hepatic, renal, or cardiac dysfunction, and of concomitant diseases or other drug therapy.
8.6Patients with Hepatic Insufficiency Plasma clearance of treprostinil, delivered subcutaneously, was reduced up to 80% in subjects with mild-to-moderate hepatic insufficiency. Uptitrate slowly when treating patients with hepatic insufficiency because of the risk of an increase in systemic exposure which may lead to an increase in dose-dependent adverse effects. Treprostinil has not been studied in patients with severe hepatic insufficiency [see Clinical Pharmacology (12.3) ] .
8.7Patients with Renal Impairment No dose adjustments are required in patients with renal impairment. Treprostinil is not cleared by dialysis [see Clinical Pharmacology (12.3) ] .
🤰 Pregnancy ▾
8.1Pregnancy Risk Summary Limited case reports of treprostinil use in pregnant women are insufficient to inform a drug-associated risk of adverse developmental outcomes. However, there are risks to the mother and the fetus associated with pulmonary arterial hypertension (see Clinical Considerations ) . In animal studies, no adverse reproductive and developmental effects were seen for treprostinil at ≥8 and ≥134 times the human exposure when based on C max and AUC, respectively, following a single, inhaled 64 mcg dose of treprostinil inhalation powder.
The estimated background risk of major birth defects and miscarriage for the indicated populations is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.
Clinical Considerations Disease-associated maternal and embryo-fetal risk Pulmonary arterial hypertension is associated with an increased risk of maternal and fetal mortality. Data Animal reproduction studies have been conducted with treprostinil via continuous subcutaneous administration and with treprostinil diolamine administered orally. In studies with orally administered treprostinil diolamine, no adverse effect doses for fetal viability/growth, fetal development (teratogenicity), and postnatal development were determined in rats.
In pregnant rats, no evidence of harm to the fetus was observed following oral administration of treprostinil diolamine at the highest dose tested (20 mg/kg/day), which represents about 129 and 1366 times the human exposure, when based on C max and AUC, respectively, following a single, inhaled 64 mcg dose of treprostinil inhalation powder. In pregnant rabbits, external fetal and soft tissue malformations and fetal skeletal malformation occurred. The dose at which no adverse effects were seen (0.5 mg/kg/day) represents about 8 and 134 times the human exposure, when based on C max and AUC, respectively, following a single, inhaled 64 mcg dose of treprostinil inhalation powder.
No treprostinil treatment-related effects on labor and delivery were seen in animal studies. Animal reproduction studies are not always predictive of human response.
🧒 Pediatric Use ▾
8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established. Clinical studies of inhaled treprostinil did not include patients younger than 18 years to determine whether they respond differently from older patients.
🧓 Geriatric Use ▾
8.5Geriatric Use Across clinical studies used to establish the effectiveness of Tyvaso Inhalation Solution in patients with PAH and PH-ILD, 268 (47.8%) patients aged 65 years and over were enrolled. The treatment effects and safety profile observed in geriatric patients were similar to younger patients. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of hepatic, renal, or cardiac dysfunction, and of concomitant diseases or other drug therapy.
🆘 Overdosage ▾
10 OVERDOSAGE In general, symptoms of overdose with inhaled treprostinil include flushing, headache, hypotension, nausea, vomiting, and diarrhea. Provide general supportive care until the symptoms of overdose have resolved.
🧬 Clinical Pharmacology ▾
12 CLINICAL PHARMACOLOGY
12.1Mechanism of Action Treprostinil is a prostacyclin analogue. The major pharmacologic actions of treprostinil are direct vasodilation of pulmonary and systemic arterial vascular beds and inhibition of platelet aggregation.
12.2Pharmacodynamics In a clinical trial of 240 healthy volunteers, single doses of Tyvaso Inhalation Solution 54 mcg (the target maintenance dose per session) and 84 mcg (supratherapeutic inhalation dose) prolonged the corrected QTc interval by approximately 10 ms. The QTc effect dissipated as the concentration of treprostinil decreased.
12.3Pharmacokinetics Absorption Treprostinil plasma exposure data were obtained from a 6-treatment, 6-period, 6-sequence, crossover study of Tyvaso DPI and Tyvaso Inhalation Solution in healthy volunteers. The mean C max for the 16, 48, and 64 mcg doses of Tyvaso DPI were 0.39, 1.11, and 1.33 ng/mL, respectively, with corresponding median T max of 0.17 hr. The mean AUC 0-5hr for the 16, 48, and 64 mcg doses of Tyvaso DPI were 0.275, 0.774, and 0.964 hr∙ng/mL, respectively.
Treprostinil systemic exposure (AUC 0-5hr and C max ) of Tyvaso DPI post-inhalation was approximately proportional to the doses administered (16 to 64 mcg). Distribution Following parenteral infusion, the steady state volume of distribution (V ss ) of treprostinil is approximately 14 L/70 kg ideal body weight. In vitro treprostinil is 91% bound to human plasma proteins over the 330 to 10,000 mcg/L concentration range.
Elimination With a single dose of Tyvaso DPI, the mean terminal half-life of treprostinil ranged from 27 to 50 minutes. Metabolism : Treprostinil is substantially metabolized by the liver, primarily by CYP2C8. Metabolites are excreted in urine (79%) and feces (13%) over 10 days.
Five apparently inactive metabolites were detected in the urine, each accounting for 10 to 15% of the dose administered. Four of the metabolites are products of oxidation of the 3-hydroxyloctyl side chain and one is a glucuroconjugated derivative (treprostinil glucuronide). Excretion : Of subcutaneously administered treprostinil, only 4% is excreted unchanged in urine.
Specific Populations Hepatic Insufficiency Plasma clearance of treprostinil, delivered subcutaneously, was reduced up to 80% in subjects presenting with mild-to-moderate hepatic insufficiency. Treprostinil has not been studied in patients with severe hepatic insufficiency [see Use in Specific Populations (8.6) ] . Renal Impairment In patients with severe renal impairment requiring dialysis (n=8), administration of a single 1 mg dose of orally administered treprostinil pre- and post-dialysis resulted in AUC 0-inf that was not significantly altered compared to healthy subjects [see Use in Specific Populations (8.7) ] .
🧬 Mechanism of Action ▾
12.1Mechanism of Action Treprostinil is a prostacyclin analogue. The major pharmacologic actions of treprostinil are direct vasodilation of pulmonary and systemic arterial vascular beds and inhibition of platelet aggregation.
📦 How Supplied / Storage and Handling ▾
16 HOW SUPPLIED/STORAGE AND HANDLING Tyvaso DPI (treprostinil) inhalation powder is available as 16 mcg, 32 mcg, 48 mcg, 64 mcg, or 80 mcg of treprostinil in single-dose plastic cartridges with approximate fill weights of 1.6 mg, 3.2 mg, 4.8 mg, 6.4 mg, or 8.0 mg of Tyvaso DPI, respectively. Four cartridges are contained in a single cavity of a blister strip. A card contains 7 blister strips separated by perforations for a total of 28 cartridges of each labeled strength in Titration and Maintenance Kits.
For convenience, the perforation allows users to remove a single blister strip containing 4 cartridges. The Institutional Kits contain 4 blister strips for a total of 16 cartridges of each labeled strength. The cartridges are color-coded, purple for 16 mcg, dark blue for 32 mcg, light blue for 48 mcg, light green for 64 mcg, and orange for 80 mcg.
Each cartridge is marked with "Tyvaso DPI" and the corresponding dosage strength of "16 mcg", "32 mcg", "48 mcg", "64 mcg", or "80 mcg". The Tyvaso DPI Inhaler is individually packaged in a clear overwrap. The inhaler is fully assembled with a removable mouthpiece cover.
The Tyvaso DPI Inhaler can be used for up to 7 days from the date of first use. After 7 days of use, the inhaler must be discarded and replaced with a new inhaler. Tyvaso DPI is available in the following configurations: Kit Contents Description NDC Number of Cartridges and Strength Number of Inhalers Tyvaso DPI (treprostinil) Inhalation Powder Titration Kit 66302-600-02 112 cartridges, each containing 16 mcg per cartridge 5 84 cartridges, each containing 32 mcg per cartridge 66302-610-02 112 cartridges, each containing 16 mcg per cartridge 5 112 cartridges, each containing 32 mcg per cartridge 28 cartridges, each containing 48 mcg per cartridge Tyvaso DPI (treprostinil) Inhalation Powder Maintenance Kit 66302-616-03 112 cartridges, each containing 16 mcg per cartridge 5 66302-632-03 112 cartridges, each containing 32 mcg per cartridge 5 66302-648-03 112 cartridges, each containing 48 mcg per cartridge 5 66302-664-03 112 cartridges, each containing 64 mcg per cartridge 5 66302-680-03 112 cartridges, each containing 80 mcg per cartridge 5 66302-620-03 112 cartridges, each containing 32 mcg per cartridge 5 112 cartridges, each containing 48 mcg per cartridge 66302-630-03 112 cartridges, each containing 32 mcg per cartridge 5 112 cartridges, each containing 64 mcg per cartridge 66302-640-03 112 cartridges, each containing 48 mcg per cartridge 5 112 cartridges, each containing 64 mcg per cartridge 66302-650-03 112 cartridges, each containing 16 mcg per cartridge 5 112 cartridges, each containing 48 mcg per cartridge 112 cartridges, each containing 64 mcg per cartridge 66302-660-03 112 cartridges, each containing 48 mcg per cartridge 5 112 cartridges, each containing 80 mcg per cartridge 66302-670-03 112 cartridges, each containing 64 mcg per cartridge 5 112 cartridges, each containing 80 mcg per cartridge Tyvaso DPI (treprostinil) Inhalation Powder Institutional Kit 66302-716-04 16 cartridges, each containing 16 mcg per cartridge 2 66302-732-04 16 cartridges, each containing 32 mcg per cartridge 2 66302-748-04 16 cartridges, each containing 48 mcg per cartridge 2 66302-764-04 16 cartridges, each containing 64 mcg per cartridge 2 66302-780-04 16 cartridges, each containing 80 mcg per cartridge 2 66302-720-04 16 cartridges, each containing 32 mcg per cartridge 2 16 cartridges, each containing 48 mcg per cartridge Blister Storage: Storage Tyvaso DPI Presentation Refrigerated storage 2°C to 8°C (36°F to 46°F) Room temperature storage 20°C to 25°C (68°F to 77°F), excursions permitted 15°C to 30°C (59°F to 86°F) Sealed (Unopened) Blister Cards or Strips May be stored until the expiration date printed on the blisters.
Must be used within 8 weeks. Opened Blister Strips Do not put a blister card or strip back into the refrigerator after being opened or stored at room temperature. Must be used within 3 days.
Inhaler Storage: Store…
📦 Storage and Handling ▾
Blister Storage: Storage Tyvaso DPI Presentation Refrigerated storage 2°C to 8°C (36°F to 46°F) Room temperature storage 20°C to 25°C (68°F to 77°F), excursions permitted 15°C to 30°C (59°F to 86°F) Sealed (Unopened) Blister Cards or Strips May be stored until the expiration date printed on the blisters. Must be used within 8 weeks. Opened Blister Strips Do not put a blister card or strip back into the refrigerator after being opened or stored at room temperature.
Must be used within 3 days.
Inhaler Storage: Store at 2°C to 25°C (36°F to 77°F); excursions permitted. The Tyvaso DPI Inhaler may be stored refrigerated but should be at room temperature for 10 minutes before use. The inhaler can be used for up to 7 days from the date of first use. After 7 days of use, the inhaler must be discarded and replaced with a new inhaler.
Handling: If refrigerated, cartridges and inhaler should be at room temperature for 10 minutes before use.
📋 Description ▾
11 DESCRIPTION
11.1Tyvaso DPI Cartridges Tyvaso DPI consists of single-dose plastic cartridges filled with a white powder containing 1% of treprostinil, a prostacyclin mimetic, which is intended for administration by oral inhalation using the Tyvaso DPI Inhaler only. Treprostinil is adsorbed onto carrier particles consisting of fumaryl diketopiperazine (FDKP). Each cartridge contains 16 mcg, 32 mcg, 48 mcg, 64 mcg, or 80 mcg of treprostinil with approximate fill weights of 1.6 mg, 3.2 mg, 4.8 mg, 6.4 mg, or 8.0 mg of Tyvaso DPI, respectively.
Treprostinil is (1 R ,2 R ,3a S ,9a S )-[[2,3,3a,4,9,9a-hexahydro-2-hydroxy-1-[(3 S )-3-hydroxyoctyl]-1 H -benz[ f ]inden-5-yl]oxy]acetic acid. Treprostinil has a molecular weight of 390.52 and a molecular formula of C 23 H 34 O 5 . The structural formula of treprostinil is: Chemical Structure
💬 Information for Patients ▾
17 PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-approved patient labeling (Instructions for Use). Train patients in the administration process for Tyvaso DPI, including dosing, Tyvaso DPI Inhaler setup, operation, cleaning, and maintenance, according to the instructions for use [see Dosage and Administration (2.1 , 2.2) ] . Advise patients that after 7 days of use, the inhaler must be discarded and replaced with a new inhaler [see Dosage and Administration (2.1) ] .
Instruct patients to use Tyvaso DPI only with the Tyvaso DPI Inhaler [see Dosage and Administration (2.1) ] . If a scheduled treatment session is missed, resume therapy as soon as possible [see Dosage and Administration (2.2) ] .