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Selexipag

Oral
Intravenous
Class
Vasoactive agents
Subclass
Prostaglandin analogs
Generic name
Selexipag
Brand names
Uptravi®
Common formulations
Tablet
Dosage and administration
Adults patients
Treatment of pulmonary hypertension • WHO group 1
•
200-1,600 mcg PO BID
Indications for use
Labeled indications
Adults
•
Treatment of pulmonary hypertension (WHO group 1)
Safety risks
Contraindications
Hypersensitivity to selexipag or any of its components
Concomitant use with strong CYP2C8 inhibitors
Warnings and precautions
Fluid retention, pulmonary edema
•
Use extreme caution in patients with underlying HF or those with a history of pulmonary edema.
Hypotension
•
Use caution in patients receiving antihypertensive medications.
Specific populations
Renal impairment
eGFR ≥ 15 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required.
eGFR < 15 mL/min/1.73 m²
•
No guidance available. Titrate with caution.
Renal replacement therapy
Continuous renal replacement
•
No guidance available.
Intermittent hemodialysis
•
Use with caution. Titrate with caution.
Peritoneal dialysis
•
Use with caution. Titrate with caution.
Hepatic impairment
Child-Pugh A (mild)
•
Use acceptable. No dose adjustment required.
Child-Pugh B (moderate)
•
Reduce dose. Start at dose of 200 mcg once daily; increase dosage in increments of 200 mcg once daily at weekly intervals as tolerated.
Child-Pugh C (severe)
•
Do not use.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B1
•
Insufficient evidence. Evidence of fetal harm in animals. AU, UK: Use is not recommended.
•
US: The manufacturer makes no recommendation regarding use during pregnancy.
•
Animal studies have failed to reveal clinically relevant effects on embryofetal development and survival. A slight decrease in fetal and maternal body weight was observed in rats at doses approximately 47 times the maximum recommended human dose. There are no controlled data in human pregnancy.
•
The use of adequate methods of contraception should be encouraged.
Breastfeeding
Little information available on breastfeeding safety.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Very common > 10%
•
Arthralgia, diarrhea, headache, jaw pain, limb pain, myalgia, nausea, skin flushing, skin rash, vomiting
Common 1-10%
•
Anemia, ↓ hemoglobin, hyperthyroidism, loss of appetite
Unknown frequency
•
Hypotension
Interactions
Drug(s)
Check Interactions
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