Riociguat

• Pulmonary arterial hypertension
• Chronic thromboembolic pulmonary hypertension

When should one not use Riociguat

• If you have severe liver impairment.
• If you have a systolic blood pressure below 95 mm Hg at the start of treatment.
• If you have pulmonary hypertension associated with idiopathic interstitial pneumonia.
• If you are taking PDE5 inhibitors at the same time.
• If you are using nitrates or nitric oxide donors along with this medicine.
• If you are using other soluble guanylate cyclase stimulators concurrently.
• If you are allergic to riociguat or any of its excipients.
• If you are pregnant.

Common side effects of this drug are:

• Headache
• Dizziness
• Indigestion
• Swelling in limbs
• Diarrhoea
• Nausea
• Vomiting
• Inflammation of the stomach or in the digestive system
• Reduction of red blood cells
• Weakness
• Palpitation
• Low blood pressure
• Nose bleed
• Nasal congestion

Other General Warnings

• You have severe liver problems
• You have recently experienced serious bleeding from the lung
• You have trouble breathing
• You have low blood pressure
• You have liver or kidney impairment
• You have cardiovascular problems
• You have hereditary galactose intolerance
• You are allergic to riociguat or any other excipients
• You are taking prescription, non-prescription medications, herbal, nutritional supplements, vitamins or minerals

How Does It Work?

Interactions with other medicines

• An increase in area under curve (AUC) of riociguat is observed when highly active antiretroviral therapy combinations are concomitantly administered
• Concomitant administration of ketoconazole increases the mean AUC of riociguat
• Inhibitors for the UDP-glycosyltransferases may potentially increase the exposure of riociguat metabolite
• Strong CYP1A1 inhibitors should be used with caution as it may increase the risk of riociguat exposure
• Medicinal products that increase gastric pH should be used with caution as they may lead to lower oral bioavailability of riociguat
• Concomitant use with CYP3A4 inducers leads to a decrease of riociguat steady-state plasma concentration
• Riociguat exposure is reduced by 50-60% in cigarette smokers
• Concomitant use of PDE5 inhibitors showed additive systemic blood pressure-lowering effect with riociguat

Overdose

Missed a Dose