Formulary
Selexipag: Indications, Dosing, Side Effects and Interactions
Selexipag is a selective prostacyclin (IP) receptor agonist.
MedNext Academy | 3 min read
Selexipag: Indications, Dosing, Side Effects and Interactions
Selexipag is a selective prostacyclin (IP) receptor agonist.
Drug action
Selexipag is a selective prostacyclin (IP) receptor agonist.
Indications and dose
**Pulmonary arterial hypertension either as combination therapy (if insufficiently controlled with an endothelin receptor antagonist and/or a phosphodiesterase type-5 inhibitor), or as monotherapy (initiated under specialist supervision)**
- **Adult** (By Mouth): Initially 200 micrograms twice daily, increased in steps of 200 micrograms twice daily at weekly intervals up to the highest tolerated dose, usual maintenance 200-1600 micrograms twice daily, initial dose and first dose after each dose increase should be taken in the evening; maximum 3200 micrograms per day.
Cautions
Elderly (limited information available)
Contraindications
Cerebrovascular event (within the last 3 months); congenital or acquired valvular defects with myocardial function disorders (not related to pulmonary hypertension); decompensated cardiac failure (unless under close medical supervision); myocardial infarction (within last 6 months); severe arrhythmias; severe coronary heart disease; unstable angina
Side effects
Common or very common Abdominal pain; anaemia; appetite decreased; arthralgia; diarrhoea; flushing; headache; hyperthyroidism; hypotension; myalgia; nasal congestion; nasopharyngitis; nausea; pain; skin reactions; vomiting; weight decreased Uncommon Sinus tachycardia
Interactions
**Other interactions (21):**
- Effect of other medicinal products on selexipag Selexipag is hydrolysed to its active metabolite by carboxylesterases (see section 5.2).
- Selexipag and its active metabolite both undergo oxidative metabolism mainly by CYP2C8 and to a smaller extent by CYP3A4.
- Selexipag and its active metabolite are substrates of OATP1B1 and OATP1B3.
- Selexipag is a weak substrate of the Pgp efflux pump.
- The pharmacokinetics of selexipag and its active metabolite are not affected by warfarin.
- Inhibitors of CYP2C8 In the presence of 600 mg gemfibrozil, twice a day, a strong inhibitor of CYP2C8, exposure to selexipag increased approximately 2-fold, whereas exposure to the active...
Pregnancy
Manufacturer advises avoid-no information available.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in moderate impairment (risk of increased exposure); avoid in severe impairment (no information available). Dose adjustments Manufacturer advises initial dose reduction to 200 micrograms once daily in moderate impairment, increased in steps of 200 micrograms once daily at weekly intervals up to the highest tolerated dose.
Renal impairment
Manufacturer advises caution with dose titration in severe impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Selexipag in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

