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Orenitram Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 4/7/2016

Orenitram (treprostinil) is a prostacyclin vasodilator used to treat pulmonary arterial hypertension (PAH) to improve exercise capacity. Common side effects of Orenitram include:

  • headache
  • nausea
  • diarrhea
  • flushing
  • jaw pain
  • pain in the extremities
  • low blood potassium (hypokalemia), or
  • abdominal discomfort

The recommended starting dose of Orenitram is 0.25 mg twice daily with food, taken approximately 12 hours apart. Increase the dose as tolerated to achieve optimal response. The recommended increment is 0.25 or 0.5 mg twice daily every 3-4 days. Orenitram may interact with diuretics, antihypertensive drugs, other vasodilators, anticoagulants, and gemfibrozil. Tell your doctor all medications and supplements you use. During pregnancy, Orenitram should be taken only if prescribed. It is unknown if this drug passes into breast milk or if it will cause undesirable effects in a nursing infant. Consult your doctor before breastfeeding.

Our Orenitram (treprostinil) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Orenitram FDA Prescribing Information: Side Effects
(Adverse Reactions)


Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

In a 12-week placebo-controlled monotherapy study (Study 1; WHO Group 1; functional class IIIII), the most commonly reported adverse reactions that occurred in patients receiving Orenitram included: headache, diarrhea, nausea,, and flushing. Table 1 lists the most common adverse reactions that occurred at a rate on Orenitram at least 5% higher than on placebo.

Orenitram patients in Table 1 for Study 1 (N = 151) had access to 0.25 mg tablets at randomization. Approximately 91% of such patients experienced an adverse reaction, but only 4% discontinued therapy for an adverse reaction (compared to 3% receiving placebo). The overall discontinuation rate for any reason was 17% for active and 14% for placebo.

Table 1: Adverse Reactions with Rates at Least 5% Higher on Orenitram Monotherapy than on Placebo

Reaction Orenitram
Headache 63% 19%
Diarrhea 30% 16%
Nausea 30% 18%
Flushing 15% 6%
Pain in jaw 11% 4%
Pain in extremity 14% 8%
Hypokalemia 9% 3%
Abdominal discomfort 6% 0%

Orenitram was studied in a long-term, open-label extension study in which 824 patients were dosed for a mean duration of approximately 2 years. About 70% of patients continued treatment with Orenitram for at least a year. The mean dose was 4.2 mg BID at one year.

The adverse reactions were similar to those observed in the placebo-controlled trials. The safety of Orenitram was also evaluated in an open-label study transitioning patients from Remodulin. The safety profile during this study was similar to that observed in the three pivotal studies.

Read the entire FDA prescribing information for Orenitram (Extended Release Osmotic Tablet)

Report Problems to the Food and Drug Administration


You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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