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Intravenous (IV) Administration

With intravenous (IV) administration, a flexible catheter is surgically placed into a central vein in the chest. IV administration allows up to 48 hours between reservoir changes.¹

Miniature Pump Options

There are a variety of pump sizes for Remodulin IV infusion, including the smallest continuous infusion prostacyclin pump available. It is the size of a cell phone or pager.

Pump Options:

Smiths Medical CADD-MS™ 3

The CADD-MS™ 3 is the size of a cell phone or pager and has multiple programming options that allow for a broad application of micro infusion therapies. It also has security pass codes for set up and programming functions to minimize the potential of patient access to programming.

Cane Crono Five

This PCA pump is suitable for subcutaneous and intravenous infusion of Remodulin. It can be used for controlled drug administration on patients in a hospital setting or undergoing therapy at home. This pump allows for 4 different administration modalities:

1. Continuous
2. Bolus dose upon request
3. Clinician bolus (managed by clinician)
4. Combined (continuous, bolus upon request, and clinician bolus)

CADD-Legacy^® 1

This ambulatory infusion pump offers infusion rates from 1 to 3,000 ml/day to meet the requirements of a wide range of continuous delivery protocols. It also offers smaller unit increments, which may help refine many programming and reporting parameters.

See individual manufacturer's instructions for proper protocol with a specific pump.

Continuous subcutaneous infusion (undiluted) of Remodulin is the preferred mode of administration. Intravenous infusion (dilution required) should only be considered if subcutaneous infusion is not tolerated or if the risks of BSI (associated with the IV route of delivery) are warranted.

Indication

Remodulin is a prostacyclin vasodilator indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to diminish symptoms associated with exercise. Studies establishing effectiveness included patients with NYHA Functional Class II-IV symptoms and etiologies of idiopathic or heritable PAH (58%), PAH associated with congenital systemic-to-pulmonary shunts (23%), or PAH associated with connective tissue diseases (19%). It may be administered as a continuous subcutaneous infusion or continuous intravenous infusion; however, because of the risks associated with chronic indwelling central venous catheters, including serious blood stream infections, continuous intravenous infusion should be reserved for patients who are intolerant of the subcutaneous route, or in whom these risks are considered warranted.

In patients with PAH requiring transition from Flolan^® (epoprostenol sodium), Remodulin is indicated to diminish the rate of clinical deterioration. The risks and benefits of each drug should be carefully considered prior to transition.

Important Safety Information for Remodulin

• Chronic intravenous infusions of Remodulin are delivered using an indwelling central venous catheter. This route is associated with the risk of blood stream infections (BSI) and sepsis, which may be fatal. Therefore, continuous subcutaneous infusion is the preferred mode of administration.
• Remodulin should be used only by clinicians experienced in the diagnosis and treatment of PAH. Remodulin is a potent pulmonary and systemic vasodilator. It lowers blood pressure, which may be further lowered by other drugs that also reduce blood pressure. Remodulin inhibits platelet aggregation and therefore, may increase the risk of bleeding, particularly in patients on anticoagulants. Remodulin dosage adjustment may be necessary if inhibitors or inducers of CYP2C8 are added or withdrawn.
• Initiation of Remodulin must be performed in a setting with adequate personnel and equipment for physiological monitoring and emergency care. Therapy with Remodulin may be used for prolonged periods, and the patient’s ability to administer Remodulin and care for an infusion system should be carefully considered.
• Remodulin dosage should be increased for lack of improvement in, or worsening of, symptoms and it should be decreased for excessive pharmacologic effects or for unacceptable infusion site symptoms.
• Abrupt withdrawal or sudden large reductions in dosage of Remodulin may result in worsening of PAH symptoms and should be avoided. Caution should be used in patients with hepatic or renal insufficiency.
• The most common side effects of Remodulin included those related to the method of infusion. For subcutaneous infusion, infusion site pain and infusion site reaction (redness and swelling) occurred in the majority of patients. These symptoms were often severe and could lead to treatment with narcotics or discontinuation of Remodulin. For intravenous infusion, line infections, sepsis, arm swelling, tingling sensations, bruising, and pain were most common. General side effects (>5% more than placebo) were diarrhea, jaw pain, vasodilatation, and edema.

For more information about REMODULIN, please see the Full Prescribing Information.
Questions? Call the Customer Service Line at 1-877-UNITHER (1-877-864-8437).