Comparison of Uptravi and Tyvaso (Inhaled Treprostinil): 5 Differences to Consider

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Pulmonary arterial hypertension (PAH) is a rare type of high blood pressure in the lungs. Medications that widen the blood vessels in the lungs can make it easier to breathe and exercise if you're living with PAH. Two common examples are Uptravi (selexipag) and Tyvaso (inhaled treprostinil). But what are the differences between them?

Here, we'll look at five differences to consider when comparing Uptravi and Tyvaso (inhaled treprostinil) for PAH.

1. Uptravi and Tyvaso work differently to treat PAH

In some ways, Uptravi and Tyvaso work similarly to treat PAH. But there are some differences in exactly how they work in the body.

PAH is caused by thickened, narrow arteries in the lungs. This raises the blood pressure in the lungs and makes it harder to breathe, especially when exercising. Prostacyclin is a hormone that helps widen the blood vessels in the body and prevents platelets (blood-clotting cells) from clumping together. Prostacyclin levels are typically lower in those living with PAH than in other people.

Tyvaso is a lab-made form of prostacyclin. When inhaled, Tyvaso helps widen the blood vessels in the lungs. This makes it easier to breathe and tolerate exercise.

Uptravi, on the other hand, isn't a form of prostacyclin. Instead, it binds to specific prostacyclin receptors (binding sites), which in turn relaxes the blood vessels in the lungs. Uptravi is FDA-approved to help slow the progression of PAH and reduce hospitalizations.

2. Uptravi is an oral capsule; Tyvaso is an inhaled medication

Uptravi and Tyvaso also have different routes of administration.

Uptravi comes as an oral tablet. It's also available as an injection for those temporarily unable to swallow capsules. It can be used alone or with other medications to treat PAH.

Tyvaso, on the other hand, is an inhaled medication. It comes in two forms: a dry powder inhaler (DPI) and a solution that's inhaled through a nebulizer machine. In most cases, you'll take other oral PAH medications along with Tyvaso.

Good to know: Tyvaso is the brand name for inhaled forms of treprostinil. But this medication is also available as an infusion (Remodulin) and an oral tablet (Orenitram).

3. Uptravi and Tyvaso have different dosing schedules

Another key difference when comparing Uptravi and Tyvaso (inhaled treprostinil) is how often you take them.

You'll take Uptravi by mouth twice a day. The Tyvaso DPI and nebulizer solution are both used four times a day (during waking hours).

Tyvaso needs to be used more often because the effects of inhaled treprostinil only last for about 4 hours. So you need to use it more often to get continued benefits. An advantage of Tyvaso is that you can plan your doses around your scheduled activities. This can help make it easier for you to participate in activities throughout the day.

For both medications, you'll start with a low dosage and slowly increase it as tolerated. This allows your body to adjust to the medication and lessens the chance of side effects.

4. Uptravi and Tyvaso have different side effects to consider

As with all medications, side effects are possible with both Uptravi and Tyvaso.

Tyvaso's side effects are generally related to the fact that it's an inhaled medication. These include cough and sore throat. Nausea is also possible if you swallow any medication. Rinsing your mouth after each treatment can help prevent it.

Common Uptravi side effects include headache, diarrhea, and nausea. Jaw pain and muscle pain are also possible. In most cases, side effects will lessen over time as your body adjusts to the medication.

Both medications can also cause flushing, headache, and dizziness. These side effects are related to the increased blood flow and drop in blood pressure that can happen when your blood vessels widen. Slowly increasing your dose of Tyvaso or Uptravi helps lessen the risk of these side effects.

5. Tyvaso and Uptravi shouldn't be taken together

Since they work similarly, in most cases you wouldn't use Tyvaso and take Uptravi at the same time. Doing so increases your chance of side effects and isn't likely to improve your PAH symptoms. But it's common to take either Tyvaso or Uptravi with other medications to help your PAH symptoms.

If you're switching from Tyvaso to Uptravi, or vice versa, there may be a period of time when you're taking both medications at once. Your prescriber will give you directions if you're switching between the medications. Be sure to let them know if you experience more side effects than usual during this time.

How to save on Uptravi and Tyvaso

Uptravi and Tyvaso are only available as brand-name medications. They're also both limited distribution drugs. This means you won't be able to get them from every pharmacy. In most cases, your prescriber will work with a specialty pharmacy that will deliver the medication to you.

The good news is that most specialty pharmacies have staff dedicated to helping you access medications and take advantage of any available discounts and savings programs. Both Uptravi and Tyvaso have patient assistance programs and copay savings available. Don't hesitate to let the pharmacy team know if you have concerns about the cost of your medication.

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