Pulmonary Arterial Hypertension (PAH) can often be managed for many years with treatments that come in a tablet form. But, intravenous medication for PAH may be recommended if you’re in a high-risk category.
Intravenous medication for PAH involves the treating drug being infused directly into the veins through a continuous line and attached pump. There are practical day-to-day challenges that come with having a line and pump, but it can mean significant improvements to your quality of life and prognosis.
When is intravenous medication for PAH considered?
A number of tests can help establish whether oral therapy (single medication or combination therapy) is suitable for you. Tests may include a right-heart catheter to determine heart pressures and cardiac output. Your history of symptoms and speed of their progression will be assessed along with issues such:
- fainting
- recording a short distance in a walk test
- right-heart failure.
If you are considered Functional Class 3 or 4 (extremely high risk), this type of treatment may be recommended. It may also be an option if you have not responded to oral therapy after a number of months. Read more about the different tests and types of treatments in our booklet, Living With Pulmonary Arterial Hypertension.
How effective is this type of treatment?
Early studies of intravenous medication for PAH have shown promising results. It can help to extend life expectancy and improve everyday quality of life, even allowing for greater freedom to do things like travel where applicable. Triple therapy (oral treatment plus intravenous medication) can provide significant improvements for people with severe disease. It’s important to remember it will vary from person-to-person and dosage needs to be regularly reviewed and increased due to a diminished response over time.
What are the practicalities and side effects?
There will inevitably be a period of adjustment for you and your family to having a permanent line in your arm or chest. The pump, which generally weighs about 400g, infuses the medication. The medication works very quickly and to maintain effect, it needs to infuse continuously for 24 hours a day. There can be complications that can include infections. You will need to adapt day-to-day activities such as showering and working and learn how to self-manage the equipment. Side effects of intravenous medication for PAH can include:
- nausea
- vomiting headache
- jaw pain
- flushing
- diarrhoea
- muscle and joint pains
Want to learn more about intravenous medication for PAH?
Pulmonary Hypertension physicians Dr John Feenstra and Dr Michael Trotter, nurse practitioner Kerri-Lee Driver and a patient representative joined us in a recent webinar to share their expertise and experiences. To find out about our webinars and other events, follow us on Facebook or Instagram.