Start with Orenitram, oral treprostinil—titrate to achieve the appropriate dose for each patient1
5 tablet strengths offer flexibility to titrate to clinical response and tolerability, with no labeled maximum dose1

How to dose Orenitram1
Initiate
at the starting dose of 0.125 mg TID
Titrate
gradually with ~weekly increases of 0.125 mg TID, or as tolerated*
Elevate
dose to achieve appropriate therapeutic benefits
- You can also choose a BID (~12 hours apart) dosing schedule, starting at 0.25 mg BID and titrating in 0.25 mg BID increments as tolerated1
- Titrate no more frequently than every 3 to 4 days.1
Titrating at 0.125 mg TID ~weekly will allow patients to reach a target dose of 3 mg TID by 6 months1

In FREEDOM-EV, achieving doses of ≥3 mg TID was associated with greater improvements in 6MWD2
- Change in 6MWD was not statistically significant at week 24 for the ITT population3
Additional dosing considerations1
- Each dose should be taken with food
- Orenitram tablets should be swallowed whole; advise patients not to crush, split, or chew
Managing missed doses1
- 1 missed dose: instruct your patient to take the missed dose as soon as possible with food
- 2 or more missed doses: restart treatment at a lower dose and retitrate
Dose interruption or discontinuation1
Situations may arise where you need to temporarily interrupt oral therapy and use parenteral therapy. Follow these guidelines to help maintain consistent therapy:
- Abrupt discontinuation or sudden large reductions in dosage of Orenitram may result in worsening of PAH symptoms
- For planned short-term interruption: consider a temporary infusion of subcutaneous or intravenous Remodulin (treprostinil) Injection
- For planned discontinuation: reduce the dose in steps of 0.5 to 1 mg per day
- If dose increments are not tolerated, try slowing or temporarily stopping titration. You can also down-titrate if needed. Avoid abrupt discontinuation
Dose adjustment in patients with hepatic impairment or use with CYP2C8 inhibitors1
- In patients with mild hepatic impairment (Child Pugh Class A), start at 0.125 mg BID with 0.125 mg BID dose increments not more frequently than every 3 to 4 days
- Avoid use of Orenitram in patients with moderate hepatic impairment (Child Pugh Class B)
- Orenitram is contraindicated in patients with severe hepatic impairment (Child Pugh Class C) due to increases in systemic exposure
- When co-administered with strong CYP2C8 inhibitors (eg, gemfibrozil), the initial dose is 0.125 mg BID with 0.125 mg BID dose increments not more frequently than every 3 to 4 days