RIOCIGUAT
-Riociguat is a medication primarily used to treat two types of pulmonary hypertension: chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary arterial hypertension (PAH). It works by stimulating soluble guanylate cyclase (sGC) and increasing cyclic guanosine monophosphate (cGMP) levels, leading to vasodilation and improved blood flow. -It is a soluble guanylate cyclase stimulator used for the treatment of pulmonary arterial hypertension (PAH).-Treatment of chronic thromboembolic pulmonary hypertension (CTEPH) after surgical treatment or inoperable cases. -Treatment of pulmonary arterial hypertension (PAH) in adults to improve exercise capacity and symptoms. -Persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), (WHO Group 4) after surgical treatment, or inoperable CTEPH, to improve exercise capacity, for the treatment of adults with pulmonary arterial hypertension (PAH), (WHO Group 1).
-The dosage may vary based on individual patient factors. It is crucial to follow the prescribing physician's instructions. Typically, riociguat is administered orally, usually three times a day. -Oral; 1mg three times a day, advised to start with 0.5mg and titrate up gradually for the response and to develop tolerance to hypotensive effect of drug, can be increased maximum upto 2.5 mg three times a day. High dose may be required in smokers.
-Concomitant use with nitric oxide donors or nitrates. -Pregnancy due to the risk of fetal harm. -Severe hepatic impairment. -Concomitant use with phosphodiesterase inhibitors or riociguat-like drugs. -Pregnancy, Pulmonary Veno-Occlusive Disease, Idiopathic Interstitial Pneumonias, with nitrates and nitric oxide donors, with PDE Inhibitors.
-Women of childbearing potential should use effective contraception during treatment. -Regular monitoring of blood pressure and liver function is recommended. -Caution in patients with hypotension or bleeding disorders. Paediatric: Safety and efficacy in pediatric patients have not been established. Pregnancy: contraindicated, Female patients of reproductive potential must have a negative pregnancy test prior to starting treatment, monthly during treatment, and one month after discontinuation of treatment. Lactation: it is not known whether it is excreted into the human breast milk, advise women not to breastfeed during treatment Elderly: No overall differences in safety or effectiveness have been observed between elderly and other adult patients.
-Common side effects may include headache, dizziness, dyspepsia, nausea, and hypotension. Serious side effects can include bleeding, pulmonary hemorrhage, and systemic hypotension. -Headache, Dyspepsia and Gastritis, Dizziness, Nausea , Diarrhea, Hypotension, Vomiting , Anemia (including laboratory parameters), Gastroesophageal reflux disease , Constipation, palpitations, nasal congestion, epistaxis, dysphagia, abdominal distension and peripheral edema.
-Riociguat should not be used with nitric oxide donors, nitrates, phosphodiesterase inhibitors, or riociguat-like drugs. -Co-administration with strong CYP1A1 inhibitors may increase riociguat exposure. -Nitrates, PDE Inhibitors, Smoking, Strong CYP And P-Gp/BCRP Inhibitors, Strong CYP3A Inducers, Antacids.
