Selexipag (Oral)

Selexipag is also known under US brand name Uptravi and is a medication that is used to treat high blood pressure in the longs. It's used to help slow down worsening of PAH (pulmonary arterial hypertension) and to decrease the chance of needing treatment in a hospital.

Overview

Selexipag is a drug that is used to treat symptoms of pulmonary arterial hypertension. This is when high blood pressure in the main arteries that carry blood from the right side of the heart to the lungs. When the smaller blood vessels located in the lungs begin to resist blood flow, the right ventricle responds by working harder to pump enough blood around the lungs. This drug works by reducing the workload of the heart by relaxing these blood vessels and increasing the supply of blood to the lungs. This medication is only available via prescription from your doctor and is available in the dosage form of tablet for oral consumption.

Conditions Treated

  • Pulmonary Arterial Hypertension

Type of Medicine

  • Tablet for oral consumption

Side Effects

Along with its intended effects, the consumption of selexipag can produce some unwanted side effects.
Inform your doctor immediately if you experience any of the following side effects while taking selexipag:

  • Chest pain
  • Swelling of the ankles and legs
  • Blue fingernails and lips
  • Coughing that sometimes produces a pink frothy sputum
  • Increased sweating
  • Fast, difficult, noisy breathing, sometimes with wheezing
  • Pale skin

Some side effects do not require urgent medical attention. If you are suffering from any of the following side effects, they should improve over time as your body naturally adjusts to the medication. If, however, you find that these side effects are disrupting your daily life, then contact a health care professional or your doctor for advice on how to minimize or prevent these side effects. Remember, that regardless of severity, you can report all side effects to the FDA on 1-800-FDA-1088.

More common:

  • Decreased appetite
  • Feeling of warmth
  • Diarrhea
  • Headache
  • Muscle cramping or aching
  • Joint pain
  • Muscle stiffness or pains
  • Rash
  • Nausea
  • Pain in the arms, jaw or legs
  • Redness of the neck, face, arms, and occasionally, upper chest
  • Vomiting
  • Swollen joints

Dosage

The final dosage of selexipag will depend on a number of factors. These include your age, height and weight, your past medical history, the severity of your condition and how you react to the first dose. Below are the typical dosage requirements with the use of selexipag. Do not change your dose requirements without consultation with your doctor or a healthcare professional.

Typical Adult Dose for Pulmonary Hypertension

The initial dose begins with 200 mcg give twice a day orally. A maintenance dose involves an increase in increments of 200 mcg given twice a day orally at weekly intervals until you find the highest amount your body can tolerate. This will be specific to the individual. The maximum dose given should not surpass 1600 mcg twice a day given orally.

Note: if the patient reaches a dose that is not tolerated, then reduce to a previously tolerated dose.

  • Do not crush, split or chew this drug.
  • Tolerability can be improved if the drug is taken with food.

Dosage in children

This will be decided individually on the advice of your doctor or a healthcare professional.

Missed dose

If you miss a dose of selexipag, you should take it as soon as you realize. If it's within six hours until the next time of your scheduled dose, then skip the missed dose. Take the next dose at the regularly scheduled time. Don't double the dose to catch up. If you have missed three days or more of medication, you should speak with your doctor on how to restart taking selexipag safety.

Interactions

Interactions with certain drugs can change how your medication works or increase your risk of serious side effects. You should, therefore, give your doctor or a healthcare professional, a list of all the products you are currently using and have used in the past. This includes prescription and nonprescription drugs, vitamins and herbal remedies. You should also give your doctor a history of past medical conditions you have suffered from, or medical conditions that run in the family. Under no circumstances should you start, stop, or change the dosage of any medications without approval from your doctor first.

Below are some of the most common drugs that interact with selexipag. Inform your doctor if you are taking any of the following drugs.

  • Amifostine
  • Alprostadil
  • Amiloride
  • Hydrochlorothiazide/ amiloride
  • Aminophylline / phenobarbital / ephedrine / potassium iodide
  • Aminophylline / ephedrine / amobarbital
  • Aminophylline / guaifenesin / ephedrine / phenobarbital
  • Amlodipine
  • Acebutolol
  • Abiraterone
  • Apomorphine
  • Amyl nitrite
  • Apraclonidine ophthalmic
  • Atenolol
  • Aspirin
  • Hydrochlorothiazide/ benazepril
  • Benazepril
  • Bendroflumethiazide
  • Nadolol / bendroflumethiazide
  • Benzthiazide
  • Bendroflumethiazide / rauwolfia serpentina
  • Benzocaine / phenylephrine / phenylpropanolamine
  • Bepridil
  • Bisoprolol
  • Betaxolol
  • Bisoprolol / hydrochlorothiazide
  • Brimonidine ophthalmic
  • Canagliflozin / metformin
  • Candesartan
  • Brimonidine topical
  • Bumetanide
  • Epimephrine/ bupivacaine
  • Canagliflozin
  • Candesartan / hydrochlorothiazide
  • Carbinoxamine / pseudoephedrine
  • Captopril
  • Captopril / hydrochlorothiazide
  • Caffine
  • Carteolol
  • Cetirizine / pseudoephedrine
  • Carvedilol
  • Chlorpheniramine / pseudoehedrine
  • Chlorthalidone
  • Clonidine
  • Clevidipine
  • Clopidogrel
  • Chlorothiazide
  • Probenecid / colchicine
  • Dapagliflozin
  • Cyclandelate
  • Dapagliflozin / metformin
  • Dapagliflozin / saxagliptin
  • Deserpidine
  • Diazoxide
  • Deferasirox
  • Dichlorphenamide
  • Divalproex sodium
  • Diltiazem
  • Doxazosin
  • Empagliflozin
  • Metformin / empagliflozin
  • Linagliptin / empagliflozin
  • Enalapril / felodipine
  • Ephedrine nasal
  • Enalapril / hydrochlorothiazide
  • Ephedrine
  • Ephedrine / potassium iodide
  • Epinephrine
  • Epinephrine / lidocaine
  • Epinephrine / etidocaine
  • Eplerenone
  • Eprosartan
  • Ethacrynic acid
  • Ethaverine
  • Eprosartan / hydrochlorothiazide
  • Esmolol
  • Felodipine
  • Fluconazole
  • Fenoldopam
  • Fxofenadine / pseudoephedrine
  • Fosinopril / hydrochlorothiazide
  • Fosinopril
  • Furazolidone
  • Glycerin
  • Furosemidegemfibrozil
  • Guanabenz
  • Guanethidine
  • Guanadrel
  • Guanethidine / hydrochlorothiazide
  • Hydralazine
  • Guanfacine
  • Hydrochlorothiazide
  • Ibuprofen / phenylephrine
  • Hydroflumethiazide
  • Indapamide
  • Irbesartan
  • Isosorbide
  • Isocarboxazid
  • Isosorbide dinitrate
  • Isoxsuprine
  • Isosorbide mononitrate
  • Lapatinib
  • Isradipine
  • Labetalol
  • Ribociclib / letrozole
  • Lisinopril
  • Linezolid
  • Loratadine / pseudoephedrine
  • Mannitol
  • Losartan
  • Maraviroc
  • Methscopolamine / phenylephrine
  • Mecamylamine
  • Methazolamide
  • Methyclothiazide
  • Metolazone
  • Methyldopa
  • Metoprolol
  • Mibefradil
  • Mifepriston
  • Minoxidil
  • Moexipril
  • Minoxidil topical
  • Nadolol
  • Nebivolol
  • Naproxen
  • Nesiritide
  • Nifedipine
  • Nicardipine
  • Nilotinib
  • Nisoldipine
  • Nimodipine
  • Nitroglycerin
  • Olmesartan
  • Nitroprusside
  • Osimertinib
  • Papaverine
  • Pamabrom
  • Penbutolol
  • Perindopril
  • Pazopanib
  • Phenelzine
  • Pindolol
  • Phenylpropanolamine
  • Polythiazide
  • Probenecid
  • Prazosin
  • Procarbazine
  • Pseudoephedrine
  • Propranolol
  • Phenoxybenzamine
  • Phenylephrine
  • Phentolamine
  • Quinapril
  • Rasagiline
  • Ramipril
  • Rauwolfia serpentina
  • Rbociclib
  • Reserpine
  • Rifampin
  • Riociguat
  • Rifapentine
  • Safinamide
  • Sacubitril / valsartan
  • Selegiline
  • Sotalol
  • Sodium nitrite
  • Sulfamethoxazole / trimethoprim
  • Spironolactone
  • Tamsulosin
  • Terazosin
  • Telmisartan
  • Teriflunomide
  • Tolazoline
  • Timolol
  • Torsemide
  • Tranylcypromine
  • Trandolapril
  • Trichlormethiazide
  • Triamterene
  • Trimethaphan camsylate
  • Valproic acid
  • Trimethoprim
  • Valsartan
  • Vilazodone
  • Verapamil

Disease interactions

There are a number of other medical problems that can affect the use of selexipag. Make sure you inform your doctor if you are suffering from any of the following medical conditions:

  • Moderate liver disease- It is recommended that the use of selexipag is with caution as the effects may be increased due to slow removal of the medicine from the body.
  • Severe liver disease- this medication is not recommended in those who suffer from severe liver disease or damage.
  • Pulmonary venous-occlusive disease- the use of selexipag is recommended with caution as it can worsen this condition.
  • A thyroid disorder
  • Kidney disease (if you are on dialysis)

Alcohol/food/tobacco

The consumption of food can make this drug easier to take, however, the use of tobacco or alcohol with some medication can cause interactions. You should discuss with your doctor or healthcare professional about the use of selexipag with tobacco or alcohol.

Warnings

Use in pediatric patients

Studies have not been conducted regarding the relationship of age to the effects of this drug on the pediatric population. Therefore efficacy and safety have not been established.

Use in geriatric patients

Various studies that have been performed to date have not indicated geriatric-specific problems that could limit the usefulness of this drug in the elderly.

Allergies

Before using this drug, you should inform your pharmacist or doctor if you are allergic to it, or if you have any other allergies including, food, animals, preservatives etc. This product could contain inactive ingredients, which could cause allergic reactions. For more information speak with your pharmacist.

It is important that your doctor or health care professional continually checks your progress to ensure this drug is working properly and to also monitor for unwanted side effects. Routine blood tests should be conducted on a regular basis.

For use in pregnancy and breastfeeding

During pregnancy, selexipag should only be used when clearly needed. You should discuss alongside your doctor, the risks and benefits associated with taking this medication. You should inform your doctor if you are planning on becoming pregnant or fall pregnant whilst taking this medication.

It is currently unknown if selexipag can pass into breast milk. You should speak with your doctor before you commence with breastfeeding whilst on this medication.

Storage

This medication needs to be stored at room temperature away from moisture and direct light. Don't store this drug in the bathroom and remember to keep all medications away from animals and children.

This medication cannot be flushed down a toilet or poured into a drain. You should consult your pharmacy on the correct method of disposal once you are finished with this product or it has expired. Never share medication with other people.

Summary

When used correctly, selexipag is successful in treating high blood pressure in the lungs. There are limited side effects associated with the use of this drug and most people experience no hassle. You should inform your doctor of all the current and past medications you are currently taken to reduce the chance of interactions and side effects. If you are pregnant, you should decide with your doctor whether the benefits of this drug outweigh the potential risks. You should not stop taking this drug without prior confirmation from your doctor. If you stop taking this medication suddenly may worsen your condition. This medication includes a patient information insert. You should ensure that you read and follow the instructions that are given carefully and closely. Contact your doctor, a healthcare professional or get in touch with your local pharmacist if you have any questions or queries regarding the use of selexipag.

 

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Last Reviewed:
February 01, 2018
Last Updated:
January 27, 2018