What is Orenitram?
Orenitram is taken with food. The recommended starting dose is 0.125 mg 3 times daily (about 8 hours apart) or 0.25 mg twice daily (about 12 hours apart). Doses may be increased as tolerated no more often than every 3 to 4 days. Tablets should be swallowed whole and should not be crushed, split, or chewed. The maximum daily dose is 120 mg.
Orenitram is an oral prostacyclin-class medicine that has been shown to help slow down the progression of PAH. It also helps improve exercise ability and decrease the symptoms of PAH. With Orenitram, there is information available for your healthcare team about how patients stable on pump therapy (treprostinil) transitioned to oral therapy. It is not known if Orenitram is safe and effective in children under 18 years of age.
Similar medicine as in a pump, but in a tablet
Orenitram is the only pill that gives you the same type of medicine (active ingredient) that is available in pump therapy. In a small study, patients in the hospital stable on pump therapy (treprostinil) successfully switched to Orenitram while maintaining their 6-minute walk distance and right heart catheterization results.
An open-label, uncontrolled (no placebo) study of 33 hospitalized patients with PAH.
Orenitram may help you reach your goals
Because Orenitram is an oral option, you may enjoy activities like being in the pool or taking a bath. Adding Orenitram has been shown to improve many measures of PAH symptoms and function, including:
- Helping to slow down the worsening of PAH
- Improving the ability to walk farther, as measured by six-minute walk distance
- Improving heart function (in the right ventricle)
- Improving the ability to do more physical activity, as measured by functional class
- Reducing shortness of breath
- Decreasing the risk of PAH getting worse (ie, improving risk status)
If you have been diagnosed recently or have had PAH for some time, Orenitram may be right for you.
Some important things to consider
For additional information, please see Patient Information for Orenitram.
Get insight and information about Orenitram and see actual patients talk about their therapy:
Before you take Orenitram, tell your healthcare provider if you:
- Have liver problems, diverticulosis, or any other medical conditions
- Are pregnant, breastfeeding, and/or plan to become pregnant or breastfeed. It is not known if Orenitram will harm your unborn baby or if Orenitram passes into your breast milk. You and your healthcare provider should decide if you will take Orenitram or breastfeed. You should not do both.
See the video below for more information on Orenitram, including dosage information.
Orenitram side effects
| Frequency | Mild | Moderate | Severe |
|---|---|---|---|
| Likely (>10%) | Headache (63%) Diarrhea (30%) Flushing (15%) Pain in the Extremity (14%) Pain in the Jaw (11%) | Nausea (30%) | |
| Less Likely (1–10%) | Abdominal Discomfort (6%) | Hypokalemia (9%) | |
| Rare (<1%) |
You need to be prepared to work through the likely adverse effects. It would be advisable for patients to get prescriptions or guidance to deal with diarrhea, nausea and headache.
- Headache is treated with Tylenol (Acetaminophen).
- Taking Orenitram with food and the right diet will help avoid nausea and diarrhea. Please see the section below on managing your diet.
- If that is not enough, diarrhea is typically treated with Imodium (Loperamide). Purchase some before you start the medication to be prepared.
- Nausea is treated first with Zofran (ondansetron).
Starting a new medication
The Access Solutions and Support Team (ASSIST) will contact you by telephone to verify your insurance information, review the next steps, and if you are eligible, discuss the available financial assistance programs. It is important to answer or return the call.
ASSIST will then forward your prescription, insurance information, and financial program eligibility to the SP best suited to provide you with Orenitram. The SP does more than a typical pharmacy and will work with your healthcare team to coordinate various aspects of your treatment, including delivering your medication.
The SP will review your current insurance information. If they need more information, someone from the SP may call you. It is important to answer or return these calls to provide the necessary information to ensure you get the support you need.
The SP will contact you to schedule a day to start your treatment and answer any questions. A nurse will visit your home to provide instructions on taking your Orenitram medication. If you have additional questions about your training or would like a refresher, you can call your SP and schedule an additional home visit.
Financial support
Non-Medicare or Medicaid patient
To enroll in this program, patients must understand and agree to comply with the eligibility requirements and terms of use.
Eligibility requirements for this program are:
- You must be 18 years or older to use this Program
- The Program is valid only for patients with commercial (also known as private) insurance who are taking the medication for an FDA-approved indication
- Patients using Medicare, Medicaid, or any other state or federal government program to pay for their medications are not eligible. Patients who start utilizing government coverage during the term of the Program will no longer be eligible
- Eligible patients must be residents of the US or Puerto Rico
An ASSIST advisor is available to discuss financial assistance for patients who have been prescribed Orenitram. If you are interested in learning more, or to find out if you or a loved one is eligible for financial assistance, ask your ASSIST advisor.
Call ASSIST at 1-877-UNITHER (1-877-864-8437).
Hours of operation: M-F 8:30 AM – 7:00 PM ET
Medicaid and Medicare patients
Non-profit charitable assistance funds:
For Medicare and Medicaid patients, foundations may be able to assist with copay support. It may take some work by you to apply. Your physician’s office, the Hub or specialty pharmacy contacts may help you through this.
We maintain an updated list and verify if funding is available on a weekly basis.
Patient support
Talk to someone who understands
Connect with other patients on Orenitram with the Orenitram PEER Mentor Network. Orenitram PEER Mentors are patients like you who have volunteered their time to help anyone on or considering Orenitram to treat PAH. They share insights on the practical lifestyle considerations associated with Orenitram.
Patient support groups
Through Pulmonary Hypertension Association, find a support group close to you.
What to expect
Pulmonary Arterial Hypertension is a serious condition. The medications designed to fight the disease typically show benefit slowly, over months, with most needing 4 to 6 months for maximum effect. The adverse effects (Side-effects) of these medications, however happen upfront. Your body typically will get used to them either with time, or with additional natural remedy or drugs. This may also take 2 to 3 months.
It is necessary that you have patience, and talk to your doctor or nurses about dealing with them. Sometimes slowing the planned increase or cutting down on medication for a while will allow your body to adjust. Discuss matters with your doctors’ office before taking action of your own. Patience is a virtue!
Managing your diet and useful downloads
