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At a glance

Selexipag is a selective non-prostanoid IP prostacyclin receptor agonist used for the treatment of pulmonary arterial hypertension (PAH, WHO Group I). It delays disease progression and reduces the risk of hospitalization.

Indications
  • Pulmonary Arterial Hypertension (PAH, WHO Group I)
Pharmacology

Selexipag activates the IP receptor, inducing vasodilation and inhibiting vascular smooth muscle cell proliferation. It is selective for the IP receptor over other prostanoid receptors (EP1-4, DP, FP, TP) unlike prostacyclin analogs.

Dosage

Adult Dose (Oral):

  • Starting: 200 mcg twice daily
  • Titration: Increase by 200 mcg twice daily at weekly intervals to the highest tolerated dose (max 1600 mcg twice daily)
  • Moderate hepatic impairment (Child-Pugh B): Start 200 mcg/day; increase by 200 mcg/day weekly
  • Severe hepatic impairment (Child-Pugh C): Avoid use
Side effects

Common Side Effects (>10%):

  • Headache (65%)
  • Diarrhea (42%)
  • Jaw pain (26%)
  • Nausea (33%)
  • Vomiting (18%)
  • Pain in extremity (17%)
  • Myalgia (16%)
  • Flushing (12%)
  • Arthralgia (11%)
  • Rash (11%)

1-10%:

  • Hemoglobin <10 g/dL (8.6%)
  • Anemia (8%)
  • Decreased appetite (6%)
Use in pregnancy

Use in Pregnancy: No adequate controlled studies in pregnant women; use only if clearly needed; consult your doctor.

Pregnancy Category: D — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • If signs of pulmonary edema occur, consider PVOD; discontinue if confirmed
  • Avoid use in severe hepatic impairment (Child-Pugh C)
  • Do not use with strong CYP2C8 inhibitors
Overdose effects

Isolated cases of overdose up to 3200 mcg reported; mild transient nausea was the only consequence; provide supportive measures.

Storage conditions

Store in a dry place, away from light and heat; keep out of reach of children.

Selexipag — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.