QuickView for Treprostinil (compound)

Summary
General Info

PubChem

PubChem Compound 11246284

Name:	treprostinil
PubChem Compound ID:	11246284
Molecular formula:	C₂₃H₃₄O₅
Molecular weight:	390.513 g/mol

DrugBank

Identification

Name:	treprostinil
Name (isomeric):	DB00374
Drug Type:	small molecule
Brand:	Viveta, Remodulin
Category:	Vitamin K antagonists, Antihypertensive Agents, Antithrombotic Agents
CAS number:	81846-19-7

Pharmacology

Indication:	For use 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 to diminish symptoms associated with exercise.
Pharmacology:	Pulmonary arterial hypertension (PAH) is a disease in which blood pressure is abnormally high in the arteries between the heart and lungs. PAH is characterized by symptoms of shortness of breath during physical exertion. The condition can ultimately lead to heart failure. Treprostinil is a potent oral antiplatelet agent. The major pharmacologic act... show more » Pulmonary arterial hypertension (PAH) is a disease in which blood pressure is abnormally high in the arteries between the heart and lungs. PAH is characterized by symptoms of shortness of breath during physical exertion. The condition can ultimately lead to heart failure. Treprostinil is a potent oral antiplatelet agent. The major pharmacologic actions of treprostinil are direct vasodilation of pulmonary and systemic arterial vascular beds and inhibition of platelet aggregation. In animals, the vasodilatory effects reduce right and left ventricular afterload and increase cardiac output and stroke volume. Other studies have shown that treprostinil causes a dose-related negative inotropic and lusitropic effect. No major effects on cardiac conduction have been observed. show less «
Mechanism of Action:	The major pharmacological actions of treprostinil are direct vasodilation of pulmonary and systemic arterial vascular beds and inhibition of platelet aggregation. In addition to treprostinil's direct vasodilatory effects, it also inhibits inflammatory cytokine. As a synthetic analogue of prostacyclin, it binds to the prostacyclin receptor, which su... show more » The major pharmacological actions of treprostinil are direct vasodilation of pulmonary and systemic arterial vascular beds and inhibition of platelet aggregation. In addition to treprostinil's direct vasodilatory effects, it also inhibits inflammatory cytokine. As a synthetic analogue of prostacyclin, it binds to the prostacyclin receptor, which subsequently induces the aforementioned downstream effects. show less «
Absorption:	Relatively rapid and complete after subcutaneous infusion, with an absolute bioavailability approximately 100%. In patients with mild (n=4) or moderate (n=5) hepatic insufficiency and portopulmonary hypertension following a subcutaneous dose of 10 ng per kg of body weight per min for 150 mins the AUC 0-∞ was increased 3-fold and 5-fold respectively.
Protein binding:	Human plasma protein binding is approximately 91% in in vitro concentrations ranging from 330 to 10,000 µ/L.
Biotransformation:	Substantially metabolized by the liver, but the precise enzymes responsible are unknown. Five metabolites have been described (HU1 through HU5) however, the biological activity and metabolic fate of these are unknown. The chemical structure of HU1 is unknown. The metabolite HU5 is the glucuronide conjugate of treprostinil. The other metabolites are formed by oxidation of the 3-hydroxyoctyl side chain (HU2) and subsequent additional oxidation (HU3) or dehydration (HU4). Study results of in vitro human hepatic cytochrome P450 demonstrates that treprostinil does not inhibit CYP-1A2, 2C9, 2C19, 2D6, 2E1, or 3A. Whether treprostinil induces these enzymes has not been studied.
Half Life:	Terminal elimination half-life is approximately 2 to 4 hours. Plasma half-life is 34 and 85 minutes for intravenous and subcutaneous infusion of the drug, respectively.
Toxicity:	Symptoms of overdose are extensions of its dose-limiting pharmacologic effects and include flushing, headache, hypotension, nausea, vomiting, and diarrhea. Most events were self-limiting and resolved with reduction or withholding of treprostinil.
Affected organisms:	Humans and other mammals

Interactions

Drug interaction:

Phenoxybenzamine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Hydrochlorothiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Guanabenz	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Bisoprolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Losartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.

Phenoxybenzamine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Hydrochlorothiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Guanabenz	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Bisoprolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Losartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nabumetone	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Nabumetone. Monitor for increased bleeding during concomitant thearpy.
Lumiracoxib	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Lumiracoxib. Monitor for increased bleeding during concomitant thearpy.
Dichlorphenamide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Metipranolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nitroprusside	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Meclofenamic acid	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Meclofenamate. Monitor for increased bleeding during concomitant thearpy.
Nitroglycerin	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Hydroflumethiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Sertraline	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Sertraline. Monitor for increased bleeding during concomitant thearpy.
Methyclothiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nifedipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Paroxetine	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Paroxetine. Monitor for increased bleeding during concomitant thearpy.
Celecoxib	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Celecoxib. Monitor for increased bleeding during concomitant thearpy.
Tizanidine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Sotalol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Carteolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Cyclandelate	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Warfarin	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Warfarin. Monitor for increased bleeding during concomitant thearpy.
Fosinopril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Hydralazine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Phentolamine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Mannitol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Ticlopidine	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Ticlopidine. Monitor for increased bleeding during concomitant thearpy.
Citalopram	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Citalopram. Monitor for increased bleeding during concomitant thearpy.
Amlodipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Enoxaparin	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Exoxaparin. Monitor for increased bleeding during concomitant thearpy.
Isradipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Bumetanide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Telmisartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Oxaprozin	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Oxaprozin. Monitor for increased bleeding during concomitant thearpy.
Eptifibatide	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Eptifibatide. Monitor for increased bleeding during concomitant thearpy.
Ketorolac	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Ketorolac. Monitor for increased bleeding during concomitant thearpy.
Nebivolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Apraclonidine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Oxprenolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Timolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Atenolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Benazepril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Heparin	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Heparin. Monitor for increased bleeding during concomitant thearpy.
Perindopril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Furosemide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Penbutolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Rivaroxaban	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Rivaroxaban. Monitor for increased bleeding during concomitant thearpy.
Carvedilol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Lisinopril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nicardipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Diflunisal	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Diflunisal. Monitor for increased bleeding during concomitant thearpy.
Amiloride	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Sulindac	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Sulindac. Monitor for increased bleeding during concomitant thearpy.
Polythiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Cilostazol	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Cilostazol. Monitor for increased bleeding during concomitant thearpy.
Minoxidil	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nadolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Fluvoxamine	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Fluvoxamine. Monitor for increased bleeding during concomitant thearpy.
Diclofenac	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Diclofenac. Monitor for increased bleeding during concomitant thearpy.
Captopril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Indomethacin	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Indomethacin. Monitor for increased bleeding during concomitant thearpy.
Clonidine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Fenoprofen	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Fenoprofen. Monitor for increased bleeding during concomitant thearpy.
Triamterene	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Celiprolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Quinapril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Levobunolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Meloxicam	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Meloxicam. Monitor for increased bleeding during concomitant thearpy.
Diltiazem	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Verapamil	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Acetazolamide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Naproxen	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Naproxen. Monitor for increased bleeding during concomitant thearpy.
Trandolapril	The prostacyclin analogue, Treprostinil, may increase the hypotensive effect of Trandolapril.
Eplerenone	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nesiritide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Salsalate	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the salicylate, Salsalate. Monitor for increased bleeding during concomitant thearpy.
Brimonidine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Guanfacine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Pindolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Cilazapril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Tolmetin	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Tolmetin. Monitor for increased bleeding during concomitant thearpy.
Spironolactone	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Eprosartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Fluoxetine	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Fluoxetine. Monitor for increased bleeding during concomitant thearpy.
Ethacrynic acid	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Candesartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Anagrelide	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Anagrelide. Monitor for increased bleeding during concomitant thearpy.
Bivalirudin	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Bivalirudin. Monitor for increased bleeding during concomitant thearpy.
Betaxolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Reserpine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Methazolamide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Olmesartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Dexmedetomidine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nisoldipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Indapamide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Torasemide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Dipyridamole	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Dipyridamole. Monitor for increased bleeding during concomitant thearpy. Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Chlorthalidone	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Trichlormethiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Piroxicam	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Piroxicam. Monitor for increased bleeding during concomitant thearpy.
Aminosalicylic Acid	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the salicylate, Aminosalicylic acid. Monitor for increased bleeding during concomitant thearpy.
Acenocoumarol	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Acenocoumarol. Monitor for increased bleeding during concomitant thearpy.
Ibuprofen	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Ibuprofen. Monitor for increased bleeding during concomitant thearpy.
Valsartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Clevidipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Drospirenone	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Argatroban	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Argatroban. Monitor for increased bleeding during concomitant thearpy.
Isosorbide Dinitrate	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Nitrendipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Lepirudin	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Lepirudin. Monitor for increased bleeding during concomitant thearpy.
Flurbiprofen	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Flurbiprofen. Monitor for increased bleeding during concomitant thearpy.
Tirofiban	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Tirofiban. Monitor for increased bleeding during concomitant thearpy.
Felodipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Drotrecogin alfa	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Drotrecogin alfa. Monitor for increased bleeding during concomitant thearpy.
Irbesartan	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Enalapril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Mefenamic acid	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Mefenamic acid. Monitor for increased bleeding during concomitant thearpy.
Terazosin	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Papaverine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Etodolac	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Etodolac. Monitor for increased bleeding during concomitant thearpy.
Acebutolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Tiaprofenic acid	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Tiaprofenic acid. Monitor for increased bleeding during concomitant thearpy.
Chlorothiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Metoprolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Metolazone	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Aliskiren	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Isosorbide Mononitrate	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Doxazosin	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Ketoprofen	The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Ketoprofen. Monitor for increased bleeding during concomitant thearpy.
Prazosin	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Esmolol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Escitalopram	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Escitalopram. Monitor for increased bleeding during concomitant thearpy.
Labetalol	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Bendroflumethiazide	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Ramipril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Acetylsalicylic acid	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Acetylsalicylic acid. Monitor for increased bleeding during concomitant thearpy.
Abciximab	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Abciximab. Monitor for increased bleeding during concomitant thearpy.
Nimodipine	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Tolazoline	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Moexipril	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Clopidogrel	The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Clopidogrel. Monitor for increased bleeding during concomitant thearpy.
Urea	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Amyl Nitrite	Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.

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Targets

Prostacyclin receptor

Peroxisome proliferator-activated receptor delta

P2Y purinoceptor 12