WARNING

Adempas (riociguat) is used to treat certain types of pulmonary hypertension. While it can be effective, it does come with risks. Some of the key concerns include:

• Low Blood Pressure: Adempas can cause a significant drop in blood pressure, which may lead to dizziness or fainting.
• Bleeding: There’s an increased risk of bleeding, including serious conditions like gastrointestinal bleeding.
• Pregnancy: It can cause birth defects, so it’s important to avoid pregnancy and use effective contraception during treatment.
• Interactions: It can interact with other medications, so it’s crucial to inform your healthcare provider about all the drugs you’re taking.
• Liver Function: Regular monitoring of liver function is needed as it can affect the liver.

Always discuss these risks with your healthcare provider to determine if Adempas is right for you and to manage any potential side effects.

Why is this medication prescribed?

Adempas (generic name: Riociguat) is prescribed for the treatment of two specific conditions:

• Chronic Thromboembolic Pulmonary Hypertension (CTEPH): This is a type of high blood pressure in the lungs that can occur after a pulmonary embolism (a blockage in the lung’s blood vessels). Adempas helps improve exercise capacity and symptoms.
• Pulmonary Arterial Hypertension (PAH): This condition involves high blood pressure in the arteries of the lungs, which can lead to heart failure and other complications. Adempas helps to reduce symptoms and improve exercise capacity in people with PAH.

Riociguat works by stimulating a substance called soluble guanylate cyclase, which helps relax and widen the blood vessels in the lungs, improving blood flow and reducing pressure.

How should this medicine be used?

Adempas (Riociguat) is typically taken orally in the form of tablets. Here are some general guidelines for its use:

• Dosage: The dosage is individualized based on the condition being treated and the patient’s response. It usually starts at a low dose and is gradually increased. It’s important to follow the prescribed dosage and schedule provided by your healthcare provider.
• Administration: The tablets should be taken with water and can be taken with or without food. It’s important to take them at the same time each day to maintain consistent levels of the medication in your body.
• Missed Dose: If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose—do not double up to make up for a missed dose.
• Monitoring: Regular follow-ups with your healthcare provider are necessary to monitor your condition and adjust the dosage if needed. They will also check for any potential side effects or interactions with other medications.
• Avoid Certain Medications: Be sure to inform your doctor about all other medications you are taking, including over-the-counter drugs and supplements, as some can interact with Adempas.
• Avoid Pregnancy: Adempas can be harmful to an unborn baby, so effective contraception is important if you are of childbearing age.

Always follow your healthcare provider’s instructions and consult them if you have any questions or concerns about using Adempas.

Other uses for this medicine

In addition to treating chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary arterial hypertension (PAH), Adempas (Riociguat) might also be investigated for other potential uses in clinical trials, but its primary approved uses are the two mentioned.

What special precautions should I follow?

Special Precautions for Adempas:

• Pregnancy and Breastfeeding: Adempas can cause harm to an unborn baby. It’s crucial to use effective contraception while on this medication and inform your doctor if you become pregnant. It’s not known if Adempas passes into breast milk. Discuss with your healthcare provider whether to breastfeed or use the medication.
• Low Blood Pressure: If you have low blood pressure or are prone to it, inform your healthcare provider. Adempas can lower blood pressure further, which might require careful monitoring.
• Kidney or Liver Issues: If you have kidney or liver problems, your doctor will need to adjust your dose or monitor you more closely, as these conditions can affect how the medication is processed in your body.
• Bleeding Disorders: Adempas can increase the risk of bleeding. If you have a history of bleeding disorders or are taking anticoagulants (blood thinners), discuss this with your healthcare provider.
• Interactions with Other Medications: Some medications can interact with Adempas, including nitrates, other pulmonary hypertension medications, or certain antifungal and antibiotic drugs. Always inform your healthcare provider about all medications and supplements you are taking.
• Alcohol: Limit alcohol consumption while taking Adempas, as it can affect how the medication works and increase the risk of side effects.
• Driving and Operating Machinery: If Adempas causes dizziness or low blood pressure, avoid activities that require alertness, like driving or operating heavy machinery, until you know how it affects you.

Always consult with your healthcare provider for personalized advice and follow their instructions closely when using Adempas.

What special dietary instructions should I follow?

• Food and Drink: Adempas can be taken with or without food. There are no specific dietary restrictions associated with it, but maintaining a balanced diet can support overall health.
• Grapefruit: While not a common interaction, it’s generally good practice to avoid excessive grapefruit or grapefruit juice, as it can affect how some medications are metabolized.

What should I do if I forget a dose?

If you forget a dose, take it as soon as you remember. If it’s close to the time of your next scheduled dose, skip the missed dose; do not double up to make up for a missed dose. Continue with your regular dosing schedule.

What side effects can this medication cause?

Adempas (Riociguat) can cause various side effects. Some of the more common and serious side effects include:

Common Side Effects:

• Headache: This is a frequent side effect and can range from mild to severe.
• Dizziness or Lightheadedness: Especially when standing up quickly or when the dose is first started.
• Fatigue: Feeling unusually tired or weak.
• Nausea: Some people may experience nausea or stomach discomfort.
• Swelling: Particularly in the legs, ankles, or feet.

Serious Side Effects:

• Severe Low Blood Pressure: Symptoms may include fainting, dizziness, or feeling very weak. This can be serious and requires immediate medical attention.
• Bleeding: Adempas can increase the risk of bleeding, including potentially serious internal bleeding. Watch for signs like unusual bruising, bleeding gums, or blood in your urine or stool.
• Liver Problems: Symptoms might include yellowing of the skin or eyes (jaundice), dark urine, or severe abdominal pain.
• Pregnancy-Related Complications: Since Adempas can harm an unborn baby, it’s crucial to avoid pregnancy and report any signs of pregnancy immediately.
• Rash, Itching, or Swelling: These could be signs of an allergic reaction and should be reported to a healthcare provider.
• Shortness of Breath: This can occur in some individuals and should be evaluated by a healthcare provider.

If you experience any side effects, especially those that are severe or persistent, it’s important to contact your healthcare provider. They can help manage these effects or adjust your treatment if necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Adempas:

• Storage:
  • Store Adempas at room temperature, away from excess heat and moisture. Typically, this means keeping it in a dry place at temperatures between 68°F to 77°F (20°C to 25°C).
  • Keep the medication in its original container with the lid tightly closed to protect it from moisture and contamination.
• Disposal:
  • The best way to dispose of unused or expired medication is to use a drug take-back program or a disposal site. Many communities have specific locations or events for safe medication disposal.
  • If a take-back program is not available, you can dispose of Adempas in your household trash by mixing it with an undesirable substance (like used coffee grounds or kitty litter) in a sealed bag or container. Be sure to remove any personal information from the prescription label before disposing of the container.

In case of emergency/overdose

• Symptoms of Overdose: Symptoms of an overdose might include severe low blood pressure, dizziness, fainting, or severe headache.
• Seek Medical Help: If you suspect an overdose, contact emergency services or go to the nearest emergency room immediately. Provide details about the medication taken and the amount.
• Contact Poison Control: You can also call Poison Control (1-800-222-1222 in the U.S.) for immediate advice on what to do.

What other information should I know?

• Regular Check-Ups: Regular follow-ups with your healthcare provider are important to monitor your condition and adjust the dosage if needed.
• Medication Interactions: Inform your healthcare provider about all other medications you are taking to avoid interactions. This includes prescription medications, over-the-counter drugs, and supplements.
• Adherence: Take Adempas exactly as prescribed. Do not stop taking it or change the dose without consulting your healthcare provider.
• Side Effects: Be aware of potential side effects and report any that are severe or concerning to your healthcare provider.
• Patient Information: Read the medication guide provided with Adempas and follow any specific instructions or warnings.

By keeping these points in mind, you can ensure that you use Adempas safely and effectively. If you have any more questions or need further clarification, don’t hesitate to reach out to your healthcare provider.