Remodulin® (treprostinil sodium) Injection is a sterile sodium salt formulated for subcutaneous or intravenous administration. Remodulin is supplied in 20 mL multi-use vials in four strengths, containing 1 mg/mL, 2.5 mg/mL, 5 mg/mL or 10 mg/mL of treprostinil. Each mL also contains 5.3 mg sodium chloride (except for the 10 mg/mL strength which contains 4.0 mg sodium chloride), 3.0 mg metacresol, 6.3 mg sodium citrate, and water for injection. Sodium hydroxide and hydrochloric acid may be added to adjust pH between 6.0 and 7.2.
Remodulin® is indicated as a continuous subcutaneous infusion or intravenous infusion (for those not able to tolerate a subcutaneous infusion) for the treatment of pulmonary arterial hypertension in patients with NYHA Class II-IV symptoms (see CLINICAL PHARMACOLOGY: Clinical Effects) to diminish symptoms associated with exercise.
Remodulin is indicated to diminish the rate of clinical deterioration in patients requiring transition from Flolan®; the risks and benefits of each drug should be carefully considered prior to transition.
Media Articles Related to Remodulin (Treprostinil Subcutaneous)
Pumpless Paracorporeal Assist Device Helps Infants With Severe Respiratory Failure Survive Until Lung Transplantation
Source: Respiratory / Asthma News From Medical News Today [2013.05.08]
Adults with end-stage respiratory failure and pulmonary hypertension requiring ECMO (extracorporeal membrane oxygenation) have been "bridged" toward lung transplantation with novel lung assist devices such as the Novalung. This and related devices work based on pumpless application of oxygenators. A presentation by David M...
Published Studies Related to Remodulin (Treprostinil Subcutaneous)
Long-term effects of inhaled treprostinil in patients with pulmonary arterial
hypertension: the Treprostinil Sodium Inhalation Used in the Management of
Pulmonary Arterial Hypertension (TRIUMPH) study open-label extension. 
patients concurrently receiving oral background therapy... CONCLUSIONS: Long-term therapy with inhaled treprostinil demonstrated persistent
Lack of a pharmacokinetic interaction between oral treprostinil and bosentan in healthy adult volunteers. [2010.07]
Treprostinil diethanolamine is an oral prostacyclin analog currently being evaluated for the treatment of pulmonary arterial hypertension (PAH). Treprostinil is metabolized primarily by cytochrome P450 (CYP) 2C8 with minor contribution from CYP2C9... In conclusion, because the GMR and 90% CI are within the equivalence interval of 0.8 to 1.25, co-administration of oral treprostinil and bosentan did not result in a pharmacokinetic interaction for either agent.
Addition of inhaled treprostinil to oral therapy for pulmonary arterial hypertension: a randomized controlled clinical trial. [2010.05.04]
OBJECTIVES: This study assessed the efficacy and safety of inhaled treprostinil in pulmonary arterial hypertension (PAH) patients receiving therapy with either bosentan or sildenafil. BACKGROUND: There is no cure for PAH, despite effective treatments, and outcomes remain suboptimal. The addition of inhaled treprostinil, a long-acting prostacyclin analog, might be a safe and effective treatment addition to other PAH-specific oral therapies... CONCLUSIONS: This trial demonstrates that, among PAH patients who remain symptomatic on bosentan or sildenafil, inhaled treprostinil improves exercise capacity and quality of life and is safe and well-tolerated. (TRIUMPH I: Double Blind Placebo Controlled Clinical Investigation Into the Efficacy and Tolerability of Inhaled Treprostinil Sodium in Patients With Severe Pulmonary Arterial Hypertension; NCT00147199). Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Exercise improvement and plasma biomarker changes with intravenous treprostinil therapy for pulmonary arterial hypertension: a placebo-controlled trial. [2010.02]
BACKGROUND: Pulmonary arterial hypertension (PAH) remains a poorly understood and frequently lethal disease with few treatment options... CONCLUSIONS: We conclude that treprostinil treatment significantly improved exercise capacity, dyspnea and functional class. Several plasma proteins that might track disease were abnormal at baseline, and changes were associated with improved exercise capacity.
Addition of inhaled treprostinil to oral therapy for pulmonary arterial
hypertension: a randomized controlled clinical trial. 
PAH-specific oral therapies... CONCLUSIONS: This trial demonstrates that, among PAH patients who remain
Clinical Trials Related to Remodulin (Treprostinil Subcutaneous)
Safety, Efficacy and Treatment Satisfaction in Patients With Pulmonary Arterial Hypertension Rapidly Switched From Epoprostenol to Remodulin [Completed]
The purpose of this 8-week study is to compare the effects of switching from therapy with
epoprostenol or Flolan to IV Remodulin. This study will also assess the effect that changing
to Remodulin will have on patient satisfaction with their treatment and impact on quality of
Study of Remodulin in Patients With Critical Limb Ischemia With No Planned Revascularization Procedures [Terminated]
The purpose of this study is to assess and compare the safety of continuous and daily
subcutaneous Remodulin therapy in patients with critical limb ischemia (CLI) with no planned
vascular interventional procedures; and to determine the effect of Remodulin on wound healing
and treadmill walk distance.
Transitioning To IV Remodulin From Ventavis in Patients With PAH: Safety, Efficacy and Treatment Satisfaction [Terminated]
The purpose of this study is to compare the effects of switching from inhaled Ventavis to
intravenous Remodulin in PAH patients who are considered to be failing inhaled Ventavis
therapy. This study is intended to provide information on the safe transition from Ventavis
to Remodulin as well as the impact intravenous Remodulin may have on overall quality of life
and treatment satisfaction compared to Ventavis.
Safety, Efficacy and Treatment Satisfaction Switching From Flolan to Remodulin Using the CronoFive Ambulatory Pump in Patients With PAH [Recruiting]
The purpose of this 8-week study is to compare the effects of switching from intravenous
Flolan to intravenous Remodulin therapy. Remodulin (treprostinil sodium) is an approved
therapy for pulmonary arterial hypertension. Unlike Flolan, Remodulin does not need to be
mixed daily and is stable at room temperature, so there is no need for ice packs. In
addition, Remodulin is changed every 48hrs, instead of every 12-24 (with ice packs) or every
8 hours (without ice packs) with Flolan. Flolan is given using a type of portable
medication pump called the CADD Legacy infusion pump. In this study, Remodulin will be given
using a smaller and lighter medication pump called the Crono Five infusion pump. This study
will also assess the effect that changing to Remodulin will have on treatment satisfaction
and patient quality of life.
Safety Study of UT-15C SR (Oral Treprostinil) in Patients Undergoing a Lower Limb Endovascular Procedure [Recruiting]
In chronic CLI patients who are appropriate candidates for endovascular procedures - and
many patients are not because of their advanced age and disease state - the treatment
regimen may include endovascular procedures such as percutaneous transluminal endovascular
intervention, as well as reconstructive surgical procedures such as grafts or bypasses.
Amputation is a last resort where limb salvage cannot be achieved. Despite the success of
percutaneous intervention for small coronary vessels with lumen diameters less than 3 mm,
similar techniques have had limited success in the lower extremity vessels. Infra-popliteal,
or below the knee endovascular intervention, is commonly plagued by subacute thrombotic
closure and restenosis in as many as 50% of treated patients. As a result of the limited
success, these percutaneous procedures have been reserved for the severest cases whereby
limb loss is imminent without intervention. In this context, the sickest of all patients are
enrolled in these trials and poor outcomes are common regardless of the intervention. Agents
that promote intracellular cAMP accumulation, including prostacyclin analogues and
phosphodiesterase inhibitors, suppress smooth muscle proliferation, promote vasodilatation
and inhibit platelet aggregation. These properties suggest that prostacyclin analogues such
as treprostinil will be useful adjuncts to peripheral endovascular intervention and perhaps
increase the number of patients with CLI that can benefit from peripheral endovascular
intervention. An orally available prostacyclin analogue could represent an important
treatment advance in the prevention of restenosis following infrapopliteal angioplasty. In
the present study, the safety and efficacy of oral UT-15C sustained release (SR) tablets
will be compared to placebo in patients with CLI undergoing an infra-popliteal endovascular
Reports of Suspected Remodulin (Treprostinil Subcutaneous) Side Effects
Infusion Site Infection (23),
Pain in Extremity (20),
Pulmonary Arterial Hypertension (17), more >>