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For the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability.
For US Healthcare Professionals Only

PAH Risk assessment

Multiple parameters are assessed to adequately determine disease severity and progression in patients with PAH.

High-risk characteristics include clinical evidence of RV failure, rapid progression of symptoms, presence of pericardial effusion, low 6MWD, high right atrial pressure, and low cardiac output.1,2

Table: Multivariate prognostic predictors.  Reference: 1

6MWD=6-minute walk distance; BNP=B-type natriuretic peptide; CI=cardiac index; CO=cardiac output; CTD=connective tissue diseases; DLCO=diffusing capacity of the lung for carbon monoxide; Echo=echocardiography; HPAH=heritable pulmonary arterial hypertension; mRAP=mean right atrial pressure; NT-proBNP=N-terminal pro–B-type natriuretic peptide; NYHA=New York Heart Association; PoPH=portopulmonary hypertension; PVOD=pulmonary veno-occlusive disease; PVR=pulmonary vascular resistance; PVRI=pulmonary vascular resistance index; WHO=World Health Organization.

Figure reproduced from McGoon et al. J Am Coll Cardiol. 2013;62(25 suppl D):D51-D59. With permission.

NEXT: Learn more about PAH Treatment Guidelines.

IMPORTANT SAFETY INFORMATION FOR TYVASO

WARNINGS AND PRECAUTIONS
DRUG INTERACTIONS / SPECIFIC POPULATIONS
ADVERSE REACTIONS

INDICATION

Tyvaso (treprostinil) is a prostacyclin vasodilator indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability. Studies establishing effectiveness included predominately 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 controlled clinical experience with inhaled treprostinil has been on a background of bosentan (an endothelin receptor antagonist) or sildenafil (a phosphodiesterase type 5 inhibitor). The controlled clinical experience was limited to 12 weeks in duration.

TYVISIhcpOCT17

Please see the Full Prescribing Information, Patient Product Information, and the TD-100 and TD-300 Tyvaso Inhalation System Instructions for Use manuals.

For additional information about Tyvaso, visit www.tyvaso.com or call 1-877-UNITHER (1-877-864-8437).

6MWD=6-minute walk distance; RV=right ventricle.

References: 1. McGoon MD, Benza RL, Escribano-Subias P, et al. Pumonary arterial hypertension: epidemiology and registries. J Am Coll Cardiol. 2013;62(25 Suppl):D51-D59. 2. McLaughlin V V, McGoon MD. Pulmonary arterial hypertension. Circulation. 2006;114(13):1417-1431.

IMPORTANT SAFETY INFORMATION FOR TYVASO

WARNINGS AND PRECAUTIONS
  • The efficacy of Tyvaso has not been established in patients with significant underlying lung disease (such as asthma or chronic obstructive pulmonary disease). Patients with acute pulmonary infections should be carefully monitored to detect any worsening of lung disease and loss of drug effect
  • Tyvaso is a pulmonary and systemic vasodilator. In patients with low systemic arterial pressure, Tyvaso may cause symptomatic hypotension
  • Titrate slowly in patients with hepatic or renal insufficiency, as exposure to treprostinil may be increased in these patients
  • Tyvaso inhibits platelet aggregation and increases the risk of bleeding
  • Co-administration of the cytochrome P450 (CYP) 2C8 enzyme inhibitor gemfibrozil may increase exposure to treprostinil. Co-administration of the CYP2C8 enzyme inducer rifampin may decrease exposure to treprostinil. Increased exposure is likely to increase adverse events, whereas decreased exposure is likely to reduce clinical effectiveness
DRUG INTERACTIONS / SPECIFIC POPULATIONS
  • The concomitant use of Tyvaso with diuretics, antihypertensives, or other vasodilators may increase the risk of symptomatic hypotension
  • Co-administration of the CYP2C8 enzyme inhibitor gemfibrozil increases exposure to oral treprostinil. Co-administration of the CYP2C8 enzyme inducer rifampin decreases exposure to oral treprostinil. It is unclear if the safety and efficacy of treprostinil by the inhalation route are altered by inhibitors or inducers of CYP2C8
  • Limited case reports of treprostinil use in pregnant women are insufficient to inform a drug-associated risk of adverse developmental outcomes. However, pulmonary arterial hypertension is associated with an increased risk of maternal and fetal mortality. There are no data on the presence of treprostinil in human milk, the effects on the breastfed infant, or the effects on milk production
  • Safety and effectiveness in pediatric patients have not been established
ADVERSE REACTIONS
  • The most common adverse reactions seen with Tyvaso in ≥4% of PAH patients and more than 3% greater than placebo in the placebo-controlled clinical study were cough (54% vs 29%), headache (41% vs 23%), throat irritation/ pharyngolaryngeal pain (25% vs 14%), nausea (19% vs 11%), flushing (15% vs <1%), and syncope (6% vs <1%). In addition, adverse reactions occurring in ≥10% of patients were dizziness and diarrhea

INDICATION

Tyvaso (treprostinil) is a prostacyclin vasodilator indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability. Studies establishing effectiveness included predominately 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 controlled clinical experience with inhaled treprostinil has been on a background of bosentan (an endothelin receptor antagonist) or sildenafil (a phosphodiesterase type 5 inhibitor). The controlled clinical experience was limited to 12 weeks in duration.

TYVISIhcpOCT17

Please see the Full Prescribing Information, Patient Product Information, and the TD-100 and TD-300 Tyvaso Inhalation System Instructions for Use manuals.

For additional information about Tyvaso, visit www.tyvaso.com or call 1-877-UNITHER (1-877-864-8437).