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How common is it to just have monotherapy instead of dual therapy? I.e. Opsumit alone

A myPHteam Member asked a question 💭
Scottsdale, AZ

I have Idiopathic PAH, Class 3. We discontinued Tidalifil as I had too many bad side effects from it and now I am on just Opsumit alone (along with Furosemide, Eliquis, Jardiance and Carvedilol). My numbers have improved quickly and dramatically with just the Opsumit and I feel pretty good. But I keep reading that patients do better long term on dual therapies. Any thoughts or experiences to share with me?

February 12, 2024
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Answer Summary

Members discussed the question of monotherapy versus dual therapy for pulmonary arterial hypertension, with several sharing that while... Read more

Members discussed the question of monotherapy versus dual therapy for pulmonary arterial hypertension, with several sharing that while research shows better outcomes when treating multiple pathways, individual responses and quality of life matter just as much as statistics. Several members offered practical guidance about alternative medications like Adempas when side effects make standard dual therapy challenging, shared experiences with insurance approval processes, and pointed to financial assistance programs such as TAF for copay help and Healthwell Foundation for grant support. A recurring theme was the importance of open communication with specialists about treatment options, not assuming insurance denials before trying, and trusting that doctors will advocate through approval hurdles when medically necessary.

A myPHteam Member

Statistically speaking, most patients fair better (i.e. live longer if they are on medications to treat at least 2 of the targeted pathways. Those on medications that target all three pathways tend to fair the best. That being said, we are all different. We respond to medications differently. PAH medications regardless of the pathway they affect can have a lot of side effects. If you are doing well on Opsumit alone, then that is appropriate for you. Numbers are important, however quality of life is even more important. I'm on Tadalafil and Ambrisentan. The plan was for me to go on Tyvaso DPI to. But on my last RHC my pulmonary pressure had dropped to 17. Obviously dual therapy is working for me. My pulmonologist suggested a wait and see approach. Tyvaso has a lot of side effects. We are waiting to see how I do physically and clinically before jumping in with both feet and hitting all three pathways.

February 12, 2024
A myPHteam Member

@A myPHteam Member an alternative to Tadalafil or Sildenafil is Adempas. Maybe that might be an option.

February 14, 2024
A myPHteam Member

@A myPHteam Member you know the old saying "Don't worry about tomorrow for today has it's own worries." Don't assume your insurance won't the medication. Worst case scenario the doctor will have to jump through some hoops to get it approved. Doctors are not unfamiliar with this process.

February 17, 2024
A myPHteam Member

supposedly I no longer need financial assistance for 2024 as I have crossed into the "catastrophic" phase of coverage which give me zero co-pays. that's why I'm afraid Wellcare won't approve it cause they will knpw they will have to pay the whole thing...plus all of my Opsumit, Eliquis, and Jardiance, all expensive meds.

February 16, 2024

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