Uptravi
Uptravi Uses, Dosage, Side Effects, Food Interaction and all others data.
Uptravi was approved by the United States FDA on December 22, 2015 for the treatment of pulmonary arterial hypertension (PAH) to delay disease progression and reduce risk of hospitalization. PAH is a relatively rare disease with usually a poor prognosis requiring more treatment options to prolong long-term outcomes. Marketed by Actelion Pharmaceuticals under brand name Uptravi, selexipag and its active metabolite, ACT-333679 (MRE-269), act as agonists of the prostacyclin receptor to increase vasodilation in the pulmonary circulation and decrease elevated pressure in the blood vessels supplying blood to the lungs.
At the maximum tolerated dose of 1600 mcg twice per day, selexipag was not found to prolong the QT interval to a clinically relevant extent. Both selexipag and its metabolite caused concentration-dependent inhibition of platelet aggregation in vitro with IC50 of 5.5 µM and 0.21 µM, respectively. However, at clinically relevant concentrations, there was no effect on platelet aggregation test parameters following multiple dose administration of selexipag in healthy patients.
Trade Name | Uptravi |
Availability | Prescription only |
Generic | Selexipag |
Selexipag Other Names | Selexipag |
Related Drugs | sildenafil, tadalafil, Revatio, Adempas, Opsumit, ambrisentan |
Weight | 1000mcg, 1200mcg, 1400mcg, 1600mcg, 200mcg, 200mcg + 800mcg, 400mcg, 600mcg, 800mcg, |
Type | Tablet, Oral Tablet |
Formula | C26H32N4O4S |
Weight | Average: 496.63 Monoisotopic: 496.2144267 |
Protein binding | Both selexipag and its active metabolite are highly protein bound, approximately 99%. |
Groups | Approved |
Therapeutic Class | |
Manufacturer | Janssen-Cilag Ltd |
Available Country | Australia, Canada, United Kingdom, United States, |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Uptravi is a non prostanoid IP prostacyclin receptor agonist used to treat pulmonary arterial hypertension.
Uptravi is indicated for the treatment of pulmonary arterial hypertension (PAH) to delay disease progression and reduce risk of hospitalization.
Uptravi is also used to associated treatment for these conditions: Pulmonary Arterial Hypertension (PAH) (WHO Group 1 PH)
How Uptravi works
Uptravi is a selective prostacyclin (IP, also called PGI2) receptor agonist. The key features of pulmonary arterial hypertension include a decrease in prostacyclin and prostacyclin synthase (enzyme that helps produce prostacyclin) in the lung. Prostacyclin is a potent vasodilator with anti-proliferative, anti-inflammatory, and anti-thrombotic effects; therefore, there is strong rationale for treatment with IP receptor agonists. Uptravi is chemically distinct as it is not PGI2 or a PGI2 analogue and has high selectivity for the IP receptor. It is metabolized by carboxylesterase 1 to yield an active metabolite (ACT-333679) that is approximately 37 times more potent than selexipag. Both selexipag and its metabolite are selective for the IP receptor over other prostanoid receptors.
Toxicity
A 40-70% increase in exposure was observed in subjects with severe renal impairment.
Food Interaction
No interactions found.[Minor] Food prolongs the gastrointestinal absorption of selexipag.
When taken with food, the time to peak concentration (Tmax) was delayed and peak plasma concentration (Cmax) was approximately 30% lower.
Uptravi systemic exposure (AUC) and that of its active metabolite did not significantly change, however.
Uptravi may be taken with or without food.
Tolerability may be improved when taken with food.
Uptravi Drug Interaction
Moderate: diltiazem, sacubitril / valsartan, dapagliflozinUnknown: fluticasone / salmeterol, fexofenadine, glimepiride, thyroid desiccated, ipratropium nasal, cranberry, diphenhydramine, multivitamin with minerals, clotrimazole, albuterol / ipratropium, cholecalciferol, roflumilast, multivitamin with minerals, glipizide, liraglutide, linagliptin, dulaglutide
Uptravi Disease Interaction
Elimination Route
After oral administration, maximum concentrations of selexipag and its metabolite were observed to be reached at 1-3 and 3-4 hours, respectively. Absorption was impaired in the presence of food, resulting in delayed time to maximum concentration as well as ~30% lower peak plasma concentration. However, exposure was not found to be significantly affected by food.
Half Life
Uptravi's terminal half life is 0.8-2.5 hours. The active metabolite's terminal half life is 6.2-13.5 hours.
Clearance
On average, 35 L/hour.
Elimination Route
93% in feces, 12% in urine.
Innovators Monograph
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