No ice packs for administration and no refrigeration for storage

Up to 2 days per reservoir

Premix up to 14 days in advance (when mixing with sterile high-pH glycine diluent)1

No ice packs for administration and no refrigeration for storage

Up to 2 days per reservoir

Premix up to 14 days in advance (when mixing with sterile high-pH glycine diluent)1

  • Storage time not concentration dependent*
  • Cannot be stored for 14 days if mixed with sterile water or 0.9% sodium chloride for injection
  • Must use an extension tube with filter
    - CADD-MS® 3 not recommended for premixing

*Stability demonstrated as low as 0.004 mg/mL.

See how Donna tackles PAH with Remodulin IV

For more information and support on Remodulin IV, contact a United Therapeutics representative.

Convenient premixing schedule

Before introducing the topic of premixing with a patient

  • Carefully consider your patient's dosing schedule, mixing proficiency, and diluent
  • Specialty Pharmacy Services (SPS) providers support your patients, answer any questions they may have about premixing, and supply the necessary diluent needed for 14-day premixing. Be sure to inform the SPS provider if you deem a patient appropriate for premixing
  • Remind patients to continue to change the reservoir no less than every 2 days1

Be sure to share the following information with your patients

  • 14-day premixing should be done only with high-pH glycine diluent. Remodulin cannot be stored for 14 days when mixed with sterile water for injection or 0.9% sodium chloride injection1
  • Tell patients to cap their reservoir tubing before storage
  • Do not use reservoirs that have been stored for more than 14 days1
  • Use extension tubing with a filter
    - The CADD-MS® 3 should not be used for premixing

Show your patients how to wear the pump


Here are some creative ways patients have developed to wear their pumps. It is important that patients do this in a manner that does not compromise the delivery of Remodulin.

  • In a passport holder worn under clothes
  • In pockets or a fanny pack
  • By sewing a “pump pocket” under the arm of a sports bra
  • In biking shorts under a dress
  • For a form-fitting dress: using an Ace™ bandage on the inside leg to keep a pump in place

This is an actual Remodulin patient.

The pump worn by the patient is the CADD-Legacy® 1.

The CADD-Legacy® 1 is a trademark of its respective owner. The maker of this brand is not affiliated with and does not endorse United Therapeutics or its products.

Specialty Pharmacy Services

Specialty Pharmacy Services (SPS) providers perform services that include

  • Dispensing medication and managing patients’ drug inventories and supplies
  • Coordinating medication refills
  • Educating healthcare providers and staff on dose optimization and adverse event management
  • Answering questions from both patients and healthcare practices

For more information and support on Remodulin IV, contact a United Therapeutics representative.

Important Safety Information for Remodulin

Warnings and Precautions

  • Chronic intravenous (IV) infusions of Remodulin are delivered using an indwelling central venous catheter. This route is associated with the risk of blood stream infections (BSI) and sepsis, which may be fatal. Therefore, continuous subcutaneous (SC) infusion is the preferred mode of administration.
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Important Safety Information for Remodulin

Warnings and Precautions

  • Chronic intravenous (IV) infusions of Remodulin are delivered using an indwelling central venous catheter. This route is associated with the risk of blood stream infections (BSI) and sepsis, which may be fatal. Therefore, continuous subcutaneous (SC) infusion is the preferred mode of administration.
  • Avoid abrupt withdrawal or sudden large reductions in dosage of Remodulin, which may result in worsening of PAH symptoms.
  • Titrate slowly in patients with hepatic or renal insufficiency because such patients will likely be exposed to greater systemic concentrations relative to patients with normal hepatic or renal function.
  • Remodulin dosage adjustment may be necessary if inhibitors or inducers of CYP2C8 are added or withdrawn. Co-administration of Remodulin with a CYP2C8 inhibitor increases exposure to treprostinil, or with an inducer, decreases exposure to treprostinil.

Drug Interactions/Specific Populations

  • Remodulin is a potent pulmonary and systemic vasodilator. Concomitant administration of Remodulin with blood pressure lowering agents, such as diuretics, antihypertensive agents, or other vasodilators, may increase the risk of symptomatic hypotension.
  • Since Remodulin inhibits platelet aggregation, there may be an increased risk of bleeding, particularly among patients receiving anticoagulants.
  • Safety and effectiveness of Remodulin in pediatric patients have not been established. It is unknown if geriatric patients respond differently than younger patients. Caution should be used when selecting a dose for geriatric patients.
  • There are no adequate and well-controlled studies with Remodulin in pregnant women. It is not known whether treprostinil is excreted in human milk.

Adverse Reactions

  • Adverse Reactions: In clinical studies of SC Remodulin infusion, the most common adverse events reported were infusion site pain and infusion site reaction (redness and swelling). These symptoms were often severe and sometimes required treatment with narcotics or discontinuation of Remodulin. The IV infusion of Remodulin has been associated with a risk of blood stream infections, arm swelling, paresthesias, hematoma, and pain. Other common adverse events (≥3% more than placebo) seen with either SC or IV Remodulin were headache, diarrhea, nausea, jaw pain, vasodilatation, and edema.

Indication

Remodulin is a prostacyclin vasodilator indicated for the treatment of pulmonary arterial hypertension (PAH; WHO Group 1) to diminish symptoms associated with exercise. Studies establishing effectiveness included patients with NYHA Functional Class II-IV symptoms and etiologies of idiopathic or heritable PAH (58%), PAH associated with congenital systemic-to-pulmonary shunts (23%), or PAH associated with connective tissue diseases (19%). It may be administered as a continuous subcutaneous infusion or continuous intravenous infusion; however, because of the risks associated with chronic indwelling central venous catheters, including serious blood stream infections, continuous intravenous infusion should be reserved for patients who are intolerant of the subcutaneous route or in whom these risks are considered warranted.

In patients with PAH requiring transition from Flolan® (epoprostenol sodium), Remodulin is indicated to diminish the rate of clinical deterioration. The risks and benefits of each drug should be carefully considered prior to transition.

Reference: 1. Remodulin [package insert]. Research Triangle Park, NC: United Therapeutics Corporation; 2014.