selexipag at a glance
Medicine class
Selective prostacyclin IP-receptor agonist
Main use
Long-term treatment of pulmonary arterial hypertension in selected adults
Specialist treatment
Started and monitored by a clinician experienced in PAH
Taking the tablets
Swallow whole with water; food may improve tolerability
What is selexipag used for?
Selexipag is licensed for long-term treatment of adults with WHO functional class II–III pulmonary arterial hypertension.
With an endothelin-receptor antagonist and/or PDE-5 inhibitor when control has not been sufficient.
On its own when a person is not a candidate for those treatments.
Supporting evidence included idiopathic or inherited PAH, PAH associated with connective-tissue disease, and PAH associated with corrected simple congenital heart disease.
How does selexipag work?
Selexipag is converted to a more active metabolite that selectively stimulates prostacyclin IP receptors. This relaxes pulmonary blood vessels, helping reduce resistance to blood flow through the lungs and slow PAH progression.
selexipag preparations and strengths
Tablet
Route: Oral
Strengths: 200 micrograms, 400 micrograms, 600 micrograms, 800 micrograms, 1000 micrograms, 1200 micrograms, 1400 micrograms, 1600 micrograms
How to take selexipag
Follow the plan from the specialist PAH team. Treatment is adjusted according to tolerability; report troublesome effects rather than changing it yourself.
Take with food if advised, as this may improve tolerability.
Swallow tablets whole with water.
Do not split or crush tablets because their coating protects selexipag from light.
People with poor vision may need help identifying tablets while treatment is being adjusted.
selexipag side effects
Common or expected effects
- Headache
- Diarrhoea
- Nausea or vomiting
- Jaw pain
- Muscle, joint or limb pain
- Flushing
- Reduced appetite or indigestion
- Nasal congestion
Get urgent medical advice
- Swelling of the face, lips, tongue or throat, or breathing difficulty suggesting angioedema
- Fainting or severe dizziness suggesting clinically important low blood pressure
- Sudden worsening breathlessness or other possible signs of pulmonary oedema
- Persistent rapid heartbeat with chest pain, fainting or marked breathlessness
selexipag in pregnancy
Selexipag is not recommended during pregnancy because human pregnancy data are unavailable. Effective contraception is advised during treatment. Anyone planning a pregnancy or who becomes pregnant should contact their PAH specialist promptly rather than stopping treatment independently.
selexipag while breastfeeding
Selexipag should not be used while breastfeeding. It is unknown whether it enters human milk, and a risk to the infant cannot be excluded. Discuss feeding and treatment options with the specialist team before birth where possible.
selexipag interactions
The PAH team should review all prescribed, over-the-counter and complementary products before treatment and whenever another medicine is started or stopped.
Gemfibrozil and other strong CYP2C8 inhibitors
They can greatly increase exposure to the active metabolite; concurrent use is contraindicated.
Clopidogrel, deferasirox or teriflunomide
These moderate CYP2C8 inhibitors increase active-metabolite exposure, so specialist review and adjustment are required.
Rifampicin, carbamazepine or phenytoin
These CYP2C8 inducers can reduce active-metabolite exposure and may reduce treatment effect.
Common questions about selexipag
Answers are fully visible for fast scanning and source review.
What is selexipag used for?
It is used for long-term treatment of selected adults with pulmonary arterial hypertension, with other PAH treatments or alone when those treatments are unsuitable.
Is selexipag a prostacyclin?
No. It is a non-prostanoid treatment that selectively activates the IP receptor involved in prostacyclin signalling.
Does selexipag cure pulmonary arterial hypertension?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.