SELEXIPAG
Background and Date of Approval
Selexipag is a pulmonary vasodilator medication approved by the U.S. Food and Drug Administration in 2015 for the treatment of pulmonary arterial hypertension (PAH).
Uses
Selexipag is used to treat pulmonary arterial hypertension (PAH) to improve exercise capacity and delay disease progression. Pulmonary arterial hypertension is a serious and rare medical condition caused by high blood pressure in the arteries that supply the lungs. It primarily affects the small blood vessels (arteries) in the lungs, leading to their narrowing and increased resistance to blood flow.
How is it administered?
Selexipag is a prescription medicine available as a tablet in various doses, Selexipag 200, 400, 600, 800, 1000, 1200, 1400, and 1600 mcg. Do not crush, chew, or open the medicine. Your physician will decide the correct dosage and duration based on age, body weight, and disease condition. Only stop taking the tablet if your doctor advises you to stop.
Side Effects
The side effects known to occur commonly during the treatment with Selexipag are weight loss, stomach pain, rashes, hyperthyroidism, and reduced appetite. Some serious side effects also include headache, diarrhea, reddening of face, vomiting, nausea, pain in the jaws, muscles, legs, or joints, and stuffy nose.
Warnings
Selexipag is contraindicated in individuals with known hypersensitivity or allergy to it or its component. It is also contraindicated if you have certain heart conditions such as severe coronary heart disease, unstable angina, recent heart attack, decompensated cardiac failure, severe irregular heartbeat, or certain heart valve defects. Also, if you have had a stroke within the last three months or any other event that reduces blood supply to the brain or are taking gemfibrozil (a medication used to lower lipid levels), this drug should not be taken.
Precautions
If you have issues with your thyroid gland, it is necessary to inform your physician. Thyroid problems can impact the treatment plan, and your doctor will consider the potential effects of this drug on your condition. This drug is contraindicated during pregnancy because it can harm a developing fetus, and breastfeeding is not recommended in patients taking Selexipag because it is unknown whether the medicine passes into the breast milk and harms your baby. This drug is metabolized and excreted by the kidneys, so if you have severe kidney problems or are undergoing dialysis, your doctor needs to determine the appropriate dosage or prescribe an alternative medicine if necessary.
Word of Advice
Selexipag is indicated for pulmonary arterial hypertension. As with other medications in this class, it may take several weeks or months to experience the full therapeutic benefit, so continued adherence to the prescribed regimen is important.
References
Janssen-Cilag Limited, Electronic medicines compendium (EMC), [Revised on June 2022] [ Accessed on 18th July 2023], https://www.medicines.org.uk/emc/files/pil.2163.pdf Actelion Pharmaceutical US, US Food and Drug Administration, [Revised on Dec 2017] [ Accessed on 18th July 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/207947s005lbl.pdf Olivier Sitbon et al.; Selexipag for the Treatment of Pulmonary Arterial Hypertension; The New England Journal of Medicine; Published on Dec 2015; Accessed on 18/07/2023; https://pubmed.ncbi.nlm.nih.gov/26699168/
Frequently Asked Questions
What is the actual mechanism of selexipag?
Selexipag works by activating the prostacyclin receptors in the blood vessels of the lungs. This activation helps to widen and relax the blood vessels, reducing the elevated blood pressure in the pulmonary arteries and improving blood flow.
What are the common side effects of selexipag?
The common side effects of selexipag include headache, jaw pain, nausea, diarrhea, muscle pain, flushing, joint pain, and pain in the extremities. These side effects are usually mild to moderate in severity. However, reporting any side effects to your physician for evaluation is important.
Are there any serious side effects associated with selexipag?
Yes, some serious side effects can occur with selexipag. These include liver problems (such as elevated liver enzymes), fluid retention, low platelet count (thrombocytopenia), and pulmonary veno-occlusive disease (a rare condition where the blood vessels in the lungs become narrowed). It's essential to seek immediate medical attention if you experience symptoms such as severe dizziness, fainting, significant weight gain, or yellowing of the skin/eyes.
Are there any medications that should not be taken with selexipag?
Yes, some medications can interact with selexipag. One example is gemfibrozil, a medication used to lower lipid levels in the blood. Gemfibrozil can increase the exposure to this drug and should not be taken concomitantly. It's important to inform your healthcare provider about all the medications, including over-the-counter drugs and supplements, that you are taking to avoid potential interactions.
What is the dosage strength of Selexipag?
Selexipag is available in tablet forms under the strength of 200, 400, 600, 800, 1000, 1200, 1400, and 1600 mcg