Patient Leaflet Updated 19-May-2022 | AOP Orphan Ltd
Trepulmix 1, 2.5, 5 & 10 mg/ml solution for infusion
Trepulmix 1 mg/ml solution for infusion
Trepulmix 2.5 mg/ml solution for infusion
Trepulmix 5 mg/ml solution for infusion
Trepulmix 10 mg/ml solution for infusion
treprostinil
1. What Trepulmix is and what it is used for
2. What you need to know before you use Trepulmix
3. How to use Trepulmix
4. Possible side effects
5. How to store Trepulmix
6. Contents of the pack and other information
The active ingredient of Trepulmix is treprostinil.
Treprostinil belongs to a group of medicines which work in a similar way to the naturally occurring prostacyclins. Prostacyclins are hormone-like substances which reduce blood pressure by relaxing blood vessels, causing them to widen, which allows the blood to flow more easily. Prostacyclins can also have an influence in preventing blood from clotting.
Trepulmix is used for the treatment of adult patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), or persistent or recurrent CTEPH after surgical treatment (severity classified WHO Functional Class (FC) III or IV), to improve exercise capacity and symptoms of the disease. Chronic thromboembolic pulmonary hypertension is a condition where your blood pressure is too high in the blood vessels between the heart and the lungs causing shortness of breath, dizziness, tiredness, fainting, palpitations or abnormal heartbeat, dry cough, chest pain and swollen ankles or legs.
Trepulmix lowers blood pressure within the pulmonary artery by improving blood flow and reducing the amount of work for the heart. Improved blood flow leads to an increased supply of oxygen to the body and reduced strain on the heart, causing it to function more effectively. Trepulmix improves the symptoms associated with CTEPH and the ability to exercise in patients who are limited in terms of activity.
Talk to your doctor before using Trepulmix if you:
During your treatment with Trepulmix, tell your doctor:
Trepulmix must not be used in children and adolescents.
Tell your doctor if you are taking/using, have recently taken/used or might take/use any other medicines. Please tell your doctor if you are taking:
Trepulmix is not recommended if you are pregnant, planning to become pregnant, or think that you might be pregnant, unless considered essential by your doctor. The safety of this medicine for use during pregnancy has not been established.
Contraception is strongly recommended during Trepulmix treatment.
Trepulmix is not recommended for use in breast-feeding, unless considered essential by your doctor. You are advised to stop breast-feeding if Trepulmix is prescribed for you, because it is not known whether this medicine passes into breast milk.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.
Trepulmix may induce low blood pressure with dizziness or fainting. In such a case do not drive or operate machinery and ask your doctor for advice.
Please tell your doctor if you are on a controlled sodium diet. They will take into account:
Trepulmix 1 mg/ml solution for infusion
This medicine contains 36.8 mg sodium (main component of cooking/table salt) in each vial. This is equivalent to 1.8% of the recommended maximum daily dietary intake of sodium for an adult.
Trepulmix 2.5 mg/ml solution for infusion
This medicine contains 37.3 mg sodium (main component of cooking/table salt) in each vial. This is equivalent to 1.9% of the recommended maximum daily dietary intake of sodium for an adult.
Trepulmix 5 mg/ml solution for infusion
This medicine contains 39.1 mg sodium (main component of cooking/table salt) in each vial. This is equivalent to 2.0% of the recommended maximum daily dietary intake of sodium for an adult.
Trepulmix 10 mg/ml solution for infusion
This medicine contains 37.4 mg sodium (main component of cooking/table salt) in each vial. This is equivalent to 1.9% of the recommended maximum daily dietary intake of sodium for an adult.
Always use this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.
Trepulmix is administered undiluted as a continuous subcutaneous infusion (under the skin) via a small tube (cannula) which is located in your abdomen or thigh;
Trepulmix is pushed through the tubing by a portable pump.
Before you leave the hospital or clinic, your doctor will tell you how to prepare Trepulmix and at what rate the pump should deliver your treprostinil. Information on how to use the pump correctly and what to do if it stops working should also be given to you. The information should also tell you who to contact in an emergency.
Flushing of the infusion line whilst connected may cause accidental overdose.
Adult patients
Trepulmix is available as 1 mg/ml, 2.5 mg/ml, 5 mg/ml or 10 mg/ml solution for infusion. Your doctor will determine the infusion rate and dose appropriate for your condition.
Elderly patients
No special dose adjustments are necessary for these patients.
Patients with liver or kidney disease
Your doctor will determine the infusion rate and dose appropriate for your condition.
Infusion rate
The infusion rate can be reduced or increased on an individual basis under medical supervision only.
The aim of adjusting the infusion rate is to establish an effective maintenance rate which improves symptoms of CTEPH while minimising any undesirable effects.
If your symptoms increase or if you need complete rest, or are confined to your bed or chair, or if any physical activity brings on discomfort and your symptoms occur at rest, do not increase your dose without medical advice. Trepulmix may no longer be sufficient to treat your disease and another treatment may be required.
If you accidentally overdose Trepulmix, you may experience nausea, vomiting, diarrhoea, low blood pressure (dizziness, light-headedness or fainting), skin flushes and/or headaches.
If any of these effects become severe you should contact your doctor or hospital immediately. Your doctor may reduce or discontinue the infusion until your symptoms have disappeared. Trepulmix solution for infusion will then be reintroduced at a dose level recommended by your doctor.
Always use Trepulmix as directed by your doctor or hospital specialist. Do not stop using Trepulmix unless your doctor has advised you to.
Abrupt withdrawal or sudden reductions in the dose of Trepulmix may cause the pulmonary arterial hypertension to return with the potential for rapid and severe deterioration in your condition.
If you have any further questions on the use of this medicine, ask your doctor.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Very common (may affect more than 1 in 10 people)
Common (may affect up to 1 in 10 people)
Uncommon (may affect up to 1 in 100 people)
Other possible side effects observed in pulmonary arterial hypertension (PAH) patients:
Other possible side effects observed during clinical practice:
If you get any side effects, talk to your doctor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
By reporting side effects you can help provide more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date that is stated on the carton and vial after “EXP”. The expiry date refers to the last day of that month.
This medicinal product does not require any special storage conditions.
A Trepulmix vial must be used or discarded within 30 days after first opening.
During continuous subcutaneous infusion, a single reservoir (syringe) of undiluted Trepulmix must be used within 72 hours.
Do not use this medicine if you notice any damage to the vial, discolouration or other signs of deterioration.
Do not throw away any medicines via waste water or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
The active substance is treprostinil.
Trepulmix 1 mg/ml solution for infusion
Each ml of solution contains 1 mg treprostinil (as sodium salt).
Each 10 ml vial of solution contains 10 mg treprostinil (as sodium salt).
Trepulmix 2.5 mg/ml solution for infusion
Each ml of solution contains 2.5 mg treprostinil (as sodium salt)
Each 10 ml vial of solution contains 25 mg treprostinil (as sodium salt).
Trepulmix 5 mg/ml solution for infusion
Each ml of solution contains 5 mg treprostinil (as sodium salt).
Each 10 ml vial of solution contains 50 mg treprostinil (as sodium salt).
Trepulmix 10 mg/ml solution for infusion
Each ml of solution contains 10 mg treprostinil (as sodium salt).
Each 10 ml vial of solution contains 100 mg treprostinil (as sodium salt).
The other ingredients are:
Sodium citrate, sodium chloride, sodium hydroxide, hydrochloric acid, metacresol and water for injections. See section 2, “Trepulmix contains sodium”.
Trepulmix is a clear colourless to slightly yellow solution, available in a 10 ml clear glass vial sealed with a rubber stopper and a colour coded cap:
Trepulmix 1 mg/ml solution for infusion
Trepulmix 1 mg/ml solution for infusion has a yellow rubber cap.
Trepulmix 2.5 mg/ml solution for infusion
Trepulmix 2.5 mg/ml solution for infusion has a blue rubber cap.
Trepulmix 5 mg/ml solution for infusion
Trepulmix 5 mg/ml solution for infusion has a green rubber cap.
Trepulmix 10 mg/ml solution for infusion
Trepulmix 10 mg/ml solution for infusion has a red rubber cap.
Each carton contains one vial.
Not all pack sizes may be marketed.
This leaflet was last revised in 01/2022.
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