How Remodulin works
For patients new to prostacyclin infusion therapy, Remodulin is started at 1.25 ng/kg/min by continuous infusion. If that is not tolerated because of systemic effects, the rate may be reduced to 0.625 ng/kg/min. The label recommends increases of 1.25 ng/kg/min per week for the first 4 weeks and 2.5 ng/kg/min per week thereafter, depending on clinical response. Remodulin should not be stopped abruptly.
PAH is a progressive condition affecting blood vessels, lungs and heart. The body may not produce enough prostacyclin, a natural substance that helps keep blood vessels open. Remodulin mimics some effects of prostacyclin, making it easier for the heart to pump blood through the lungs and potentially improving exercise-related symptoms such as shortness of breath and fatigue.
Remodulin provides medication 24 hours a day and does not require refrigeration for storage.
Safety and side-effect management
Before taking Remodulin, tell your healthcare provider about other medical conditions and medicines, liver or kidney problems, low blood pressure, bleeding problems, gemfibrozil, rifampin, pregnancy, plans for pregnancy, or breastfeeding.
Your specialty pharmacy nurse and healthcare team can help manage side effects. Communicate side effects with your care team and do not suddenly discontinue Remodulin; sudden stoppage may be dangerous.
- Nausea/vomiting: taking with food, small frequent meals, ginger-based foods, or asking your provider about anti-nausea medication may help.
- Diarrhea: discuss titration and dietary changes with your care team; over-the-counter or prescription antidiarrheal medicines may be recommended.
- Headache: acetaminophen is commonly used; ask your care team if headaches persist.
- Dizziness can be serious; discuss it with your care team and use caution with sudden position changes.
- Jaw pain often improves with time; slow bites or sips, crackers, hard candy or gum before eating may help.
- Flushing is usually not dangerous; cold packs or a cool compress may help.
Starting Remodulin IV
Remodulin IV is delivered directly into the bloodstream through a narrow flexible catheter. To start therapy, you will be admitted to the hospital, where a doctor places the catheter in a vein in the upper chest. The procedure generally takes about an hour and a half and requires an overnight hospital stay. The catheter connects to a pump that continuously delivers medication.
- No ice packs for administration and no refrigeration for storage.
- Up to 2 days between reservoir changes.
- A specialty pharmacy nurse provides step-by-step training and ongoing support.
- Medication, supplies and refills are delivered through a Specialty Pharmacy.
- Support can include follow-up calls, home nurse visits if needed, and a 24-hour patient hotline.
Financial support
Remodulin Copayment Assistance Program
United Therapeutics offers copay assistance for eligible commercially insured patients. Enrollment information is available through ASSIST at 1-877-864-8437. Medicare, Medicaid and other government-program patients are not eligible for the commercial copay program.
Other assistance may be available through ASSIST. Medicare and Medicaid patients may also be able to seek copay support through charitable assistance foundations.
Patient support
The Remodulin Support Program offers treatment information and a Remodulin Patient Journal. United by PAH provides PAH information and support resources. The PEER Network connects patients and caregivers with volunteer mentors; call 1-866-505-7337 for more information.
Expectations
PAH is a serious condition. Benefits from treatment may develop gradually while side effects can occur early. Talk with your doctor or nurses about managing side effects. Do not change or reduce medication on your own.
Life with PAH and resources
For additional PAH education and support, see the Pulmonary Hypertension Association, NHLBI, and American Heart Association.