Uptravi
Uptravi (selexipag) is a prostacyclin agonist that's used in adults to treat pulmonary arterial hypertension (PAH), which is high blood pressure in the lungs. This medication can help prevent PAH from getting worse and lower the risk for hospitalization. Uptravi (selexipag) is a tablet that's taken by mouth twice per day. It's also available as an intravenous (IV) injection for people who can't take the medication by mouth. The most common side effects include headache, diarrhea, and nausea.
What is Uptravi (selexipag)?
What is Uptravi (selexipag) used for?
- Pulmonary arterial hypertension or PAH (high blood pressure in the blood vessels in your lungs)
How Uptravi (selexipag) works
Uptravi (selexipag) is a prostacyclin agonist. It acts like prostacyclin, a natural chemical in your body, to relax the blood vessels in your lungs. This lowers the blood pressure in your lungs and allows more blood to flow through. As a result, your heart is able to pump better, your body gets more oxygen, and you should be able to breathe and exercise easier.
Drug facts
Side effects of Uptravi (selexipag)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (65%)
- Diarrhea (42%)
- Nausea (33%)
- Jaw pain (26%)
- Vomiting (18%)
- Pain in arms or legs (17%)
- Muscle pain (16%)
- Flushing (12%)
Less Common Side Effects
- Joint pain
- Rash
- Low appetite
- Anemia (low red blood cell count)
- Low blood pressure (e.g., dizziness, lightheadedness, feeling faint)
The following Uptravi (selexipag) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Diarrhea
- Headache
- Muscle pain
- Nausea
- Pain in the hands or feet
- Vomiting
Pros and cons of Uptravi (selexipag)
Pros
- Can help prevent PAH from getting worse and lower the risk for hospitalizations
- Tablets available in many different strengths
- Available as an injection for people who temporarily can't take the medication by mouth
Cons
- Can have a lot of side effects
- Dose needs to be raised slowly
- Not known if it's safe to take while pregnant or breastfeeding
Pharmacist tips for Uptravi (selexipag)
- You can take Uptravi (selexipag) with or without food. Taking it with food can help lower the risk of stomach-related side effects (e.g., nausea, vomiting, diarrhea).
- Swallow the tablets whole. Don't split, crush, or chew the tablets.
- If you miss a dose of Uptravi (selexipag) and your next dose is more than 6 hours away, take the medication as soon as you remember. But if your following dose is within the next 6 hours, skip the missed dose and take your next dose at your regular scheduled time.
- If you haven't taken Uptravi (selexipag) for at least 3 days, contact your provider before you take the medication. You might need to restart Uptravi (selexipag) at a lower dose.
- Since Uptravi (selexipag) can interact with other medications, make sure to tell your provider and pharmacist about all the medications you're taking, including over-the-counter products and supplements. Don't start any new medications while you're taking Uptravi (selexipag) without talking to your providers first. They can make sure all your medications are safe to take together and adjust any doses.
- Talk to your provider to see whether you can take Uptravi (selexipag) if you're pregnant, thinking of getting pregnant, or breastfeeding. There haven't been enough studies looking at how safe the medication is during pregnancy or breastfeeding. In animal pregnancy studies, Uptravi (selexipag) didn't cause harm to unborn babies, but these results aren't always the same as what could happen in humans.
Common questions about Uptravi (selexipag)
In clinical studies, Uptravi (selexipag) lowered the risk of PAH progression by 40% when treatment with the medication was compared to placebo. This also included lowering the risk of hospitalization for PAH; the need to start injectable PAH medications, long-term oxygen therapy, or additional PAH medications; the need for a lung transplant; or death. Talk to your provider if you have questions about how well Uptravi (selexipag) works for you.
Uptravi (selexipag) doesn't raise the risk of bleeding, so it's generally safe to take before surgery. To be safe, make sure to tell your provider or surgeon about all of your medications, including Uptravi (selexipag), before you get any procedures or surgeries done. Follow your provider's directions if there are specific instructions on how to take Uptravi (selexipag) before or after the procedure.
It's possible for Uptravi (selexipag) to lower blood pressure. This medication helps relax and open up your blood vessels so blood can flow more easily between the lungs and heart. This might lower your blood pressure as a result. Some people who took Uptravi (selexipag) felt symptoms of low blood pressure, such as feeling lightheaded or dizzy. Make sure to carefully get up from a sitting or lying position and try to hold onto something to prevent a sudden drop in blood pressure when you change positions. Let your provider know if you're taking any medications for high blood pressure and if you feel lightheaded, dizzy, or like you're about to faint.
Uptravi (selexipag) doesn't typically cause nasopharyngitis (the common cold). Talk to your provider or pharmacist if you start having a cold while you're taking Uptravi (selexipag). Your providers can recommend ways to relieve your cold symptoms.
Uptravi (selexipag) doesn't weaken your joints, bones, or tendons, but it can sometimes cause pain in the body as a side effect. In studies, people taking this medication commonly reported some pain throughout the body, such as in the joints, jaw, muscles, arms, or legs. Talk to your provider if you're having pain that's too bothersome and is affecting your daily activities. Your provider might lower your dose, switch you to a different medication, or recommend a safe, over-the-counter pain reliever for you.
Hot flashes weren't specifically reported by people who took Uptravi (selexipag) in clinical studies. But 12% of people who took the medication during the studies reported flushing (when your skin gets red and sometimes feel a little warm), which can also be a symptom of a hot flash. Talk to your provider if you have any bothersome hot flashes while you're taking Uptravi (selexipag).
No, insomnia (difficulty sleeping) isn't a typical side effect of Uptravi (selexipag). Let your provider know if you have difficulty sleeping while you're taking Uptravi (selexipag). Your provider can discuss with you about what might be making you have trouble sleeping.
No, Uptravi (selexipag) doesn't appear to affect vision. So far, changes in vision haven't been reported while people take the medication. See your optometrist (eye provider) if you notice any changes in vision so you can get examined for a more serious medical problem.
No. Unlike other PAH medications like ambrisentan (Letairis), Uptravi (selexipag) doesn't typically cause water retention (fluid buildup in the body). Keep in mind that water retention is also a symptom of PAH. Contact your provider right away if you notice fluid buildup in your arms or legs (which looks like swelling) or if you're having trouble breathing or coughing. This could be a sign of a rare form of pulmonary hypertension or worsening PAH, and you might need an adjustment to your PAH medications like Uptravi (selexipag).
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Risks and warnings for Uptravi (selexipag)
Uptravi (selexipag) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Excess fluid in lungs
Excess fluid in the lungs (pulmonary edema) can be a sign of a rare form of pulmonary hypertension. Contact your provider if you notice signs of pulmonary edema, such as shortness of breath, tiredness (especially with physical activity), chest pain, or coughing that doesn't go away. You should be tested for this rare form of pulmonary hypertension. And you'll need to stop Uptravi (selexipag) if it's confirmed you have this condition.
Uptravi (selexipag) dosage
Typical dosage for Uptravi (selexipag)
The typical starting dose is 200 mcg by mouth twice daily. Your provider will slowly raise your dose to the highest dose you can tolerate. The maximum dose is 1,600 mcg twice daily.
Your dose might differ if you have liver problems. It might also differ you're taking certain medications that can interact with Uptravi (selexipag), such as clopidogrel (Plavix) or rifampin (Rifadin).
Uptravi (selexipag) is also available as an intravenous (IV) infusion into your veins that's given by a healthcare provider in the hospital.
Uptravi (selexipag) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Uptravi (selexipag) will not be safe for you to take.
- Take certain medications that interact with Uptravi (selexipag), like gemfibrozil (Lopid)
What are alternatives to Uptravi (selexipag)?
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