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Selexipag oral

Updated 2 Feb 2023 | Prostacyclin analogues


Oral formulations of selexipag.

Drugs List

  • selexipag 1.2mg tablets
  • selexipag 1.4mg tablets
  • selexipag 1.6mg tablets
  • selexipag 1mg tablets
  • selexipag 200microgram tablets
  • selexipag 400microgram tablets
  • selexipag 600microgram tablets
  • selexipag 800microgram tablets
  • UPTRAVI 1000microgram film coated tablets
  • UPTRAVI 1200microgram film coated tablets
  • UPTRAVI 1400microgram film coated tablets
  • UPTRAVI 1600microgram film coated tablets
  • UPTRAVI 200microgram film coated tablets
  • UPTRAVI 400microgram film coated tablets
  • UPTRAVI 600microgram film coated tablets
  • UPTRAVI 800microgram film coated tablets
  • Therapeutic Indications


    Pulmonary arterial hypertension: functional grades II and III

    Selexipag is indicated for the long term treatment of pulmonary arterial hypertension (PAH) in patients with WHO functional class (FC) II to III, either as combination therapy in patients insufficiently controlled with an endothelin receptor antagonist (ERA) and/or a phosphodiesterase type 5 (PDE-5) inhibitor or as a monotherapy in patients who are not candidates for these therapies.

    Efficacy has been shown in a PAH population including idiopathic and heritable PAH, PAH associated with connective tissue disorders, and PAH associated with corrected simple congenital heart disease.



    Individualised dose titrations
    Each patient should be up-titrated to the highest individually tolerated dose, which can range from 200micrograms given twice daily to 1.6mg given twice daily (individualised maintenance dose).

    The recommended starting dose is 200micrograms given twice daily, approximately 12 hours apart. The dose is increased in increments of 200micrograms given twice daily, usually at weekly intervals. At the beginning of treatment and at each up-titration step it is recommended to take the first dose in the evening.
    If the patient reaches a dose that cannot be tolerated, the dose should be reduced to the previous dose level.

    In patients in whom up-titration was limited by reasons other than adverse reactions reflecting the mode of action of selexipag, a second attempt to continue up-titration to the highest individually tolerated dose up to a maximum dose of 1.6mg twice daily may be considered.

    Individualised maintenance dose
    The highest tolerated dose reached during dose titration should be maintained. If the therapy over time is less tolerated at a given dose, symptomatic treatment and/or a dose reduction to the next lower dose should be considered.

    Patients with Renal Impairment

    Severe renal impairment (eGFR less than 30 ml/minute/1.73 metres squared)
    Dose titration should be done with caution in these patients.

    Patients with Hepatic Impairment

    Moderate hepatic impairment (Child-Pugh class B)
    The starting dose of selexipag should be 200micrograms once daily, and increased at weekly intervals by increments of 200micrograms given once daily until adverse reactions, reflecting the mode of action of selexipag, that cannot be tolerated or medically managed are experienced.

    Additional Dosage Information

    Missed dose
    If a dose is missed, it should be taken as soon as possible. The missed dose should not be taken if the next scheduled dose is within approximately 6 hours.

    If treatment is missed for 3 days or more, selexipag should be restarted at a lower dose and then up-titrated.


    Children under 18 years
    Decompensated cardiac failure
    Ischaemic heart disease
    Renal dialysis
    Serious cardiac arrhythmias
    Severe hepatic impairment
    Unstable angina
    Valvular defects with associated myocardial function disorder
    Within 3 months of a cerebrovascular accident
    Within 6 months of a myocardial infarction

    Precautions and Warnings

    Females of childbearing potential
    Patients over 75 years
    Autonomic dysfunction
    Left ventricular outflow obstruction
    Moderate hepatic impairment
    Pulmonary veno-occlusive disease
    Renal impairment - eGFR below 30ml/minute/1.73m sq

    Reduce dose in patients with moderate hepatic impairment
    Advise ability to drive/operate machinery may be affected by side effects
    Treatment to be initiated and supervised by a specialist
    Monitor thyroid function regularly
    Consider veno-occlusive disease if pulmonary oedema occurs
    Avoid abrupt withdrawal
    Discontinue if pulmonary oedema occurs
    Female: Ensure adequate contraception during treatment

    There is limited experience with abrupt discontinuation of selexipag in patients with PAH. No evidence for acute rebound has been observed. If the decision to withdraw selexipag is taken, it should be done gradually while an alternative therapy is introduced.

    Pregnancy and Lactation


    Selexipag is contraindicated during pregnancy.

    The manufacturer does not recommend using selexipag during pregnancy. At the time of writing there is limited published information regarding the use of selexipag during pregnancy. Potential risks are unknown.


    Selexipag is contraindicated during breastfeeding.

    The manufacturer does not recommend breastfeeding whilst taking selexipag. The presence of selexipag in human breast milk and the effects on exposed infants are unknown.

    Side Effects

    Abdominal pain
    Decreased appetite
    Decreased TSH
    Extremity pain
    Haemoglobin decrease
    Jaw pain
    Nasal congestion
    Weight loss


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: October 2019

    Reference Sources

    Summary of Product Characteristics: Uptravi. Actelion Pharmaceuticals UK Ltd. Revised July 2019.

    NICE Evidence Services Available at: Last accessed: 25 October 2019

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