Riociguat

What is Riociguat

Riociguat is an oral soluble guanylate cyclase stimulator and is indicated for the treatment of adults with pulmonary arterial hypertension (PAH) (WHO group I) and patients with persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) (WHO Group 4) after surgical treatment or inoperable CTEPH.

Riociguat is the first FDA-approved soluble guanylate cyclase stimulator to treat PAH and the first drug of any class to show efficacy for patients with CTEPH. 

Brand Name

Adempas

Indications & Dosage

  • pulmonary hypertension

For the treatment of pulmonary hypertension in patients with persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), (WHO Group 4) after surgical treatment, or inoperable CTEPH, to improve exercise capacity and WHO functional class or pulmonary arterial hypertension (PAH), (WHO Group 1), to improve exercise capacity, WHO functional class and to delay clinical worsening

Side Effects

  1. anemia
  2. bleeding
  3. constipation
  4. diarrhea
  5. dizziness
  6. dyspepsia
  7. dysphagia
  8. epistaxis
  9. gastritis
  10. gastroesophageal reflux
  11. headache
  12. hematemesis
  13. hemoptysis
  14. hypotension
  15. nasal congestion
  16. nausea
  17. palpitations
  18. peripheral edema
  19. pulmonary edema
  20. spontaneous fetal abortion
  21. subdural hematoma
  22. teratogenesis
  23. vaginal bleeding
  24. vomiting

Monitoring Parameters

  • blood pressure
  • pregnancy testing

Contraindications

  • breast-feeding
  • contraception requirements
  • hypotension
  • hypovolemia
  • idiopathic interstitial pneumonia
  • pregnancy
  • pregnancy testing
  • pulmonary edema
  • reproductive risk
  • tobacco smoking

Interactions

  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Aluminum Hydroxide
  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Antacids
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Articaine; Epinephrine
  • Aspirin, ASA; Dipyridamole
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Avanafil
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzphetamine
  • Boceprevir
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Cilostazol
  • Codeine; Phenylephrine; Promethazine
  • Conivaptan
  • Daclatasvir
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desloratadine; Pseudoephedrine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Diethylpropion
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Dipyridamole
  • Dobutamine
  • Dopamine
  • Duloxetine
  • Elbasvir; Grazoprevir
  • Enzalutamide
  • Ephedrine
  • Epinephrine
  • Fexofenadine; Pseudoephedrine
  • Fosamprenavir
  • Fosphenytoin
  • Gemfibrozil
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibuprofen; Pseudoephedrine
  • Indinavir
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isoproterenol
  • Itraconazole
  • Ketoconazole
  • Lisdexamfetamine
  • Lopinavir; Ritonavir
  • Loratadine; Pseudoephedrine
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lurasidone
  • Magnesium Hydroxide
  • Mepivacaine; Levonordefrin
  • Methamphetamine
  • Methylphenidate
  • Midodrine
  • Milrinone
  • Mitotane
  • Naproxen; Pseudoephedrine
  • Nefazodone
  • Nitrates
  • Norepinephrine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Pemoline
  • Phendimetrazine
  • Phenobarbital
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Prilocaine; Epinephrine
  • Pseudoephedrine
  • Racepinephrine
  • Rifampin
  • Ritodrine
  • Ritonavir
  • Roflumilast
  • Sapropterin
  • Sildenafil
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • St. John’s Wort, Hypericum perforatum
  • Sympathomimetics
  • Tadalafil
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Temsirolimus
  • Theophylline, Aminophylline
  • Tipranavir
  • tobacco
  • Tucatinib
  • Vardenafil
  • Zafirlukast
  • Zonisamide
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