WARNING

Riociguat is a medication primarily used to treat pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). While it can be effective in managing these conditions, like any medication, it comes with potential risks and side effects. It’s crucial to consult with a healthcare professional for personalized advice, but here are some general risks associated with riociguat:

• Hypotension (Low Blood Pressure): Riociguat can cause a drop in blood pressure, leading to symptoms such as dizziness and fainting. Patients with low baseline blood pressure or those taking medications that lower blood pressure are at higher risk.
• Bleeding: Riociguat may increase the risk of bleeding. This risk is particularly relevant for patients with a history of bleeding disorders or those taking anticoagulant medications.
• Pregnancy and Birth Defects: Riociguat can cause harm to the fetus, so it is not recommended during pregnancy. Women of childbearing age are typically advised to use effective contraception during riociguat treatment and for at least one month after stopping the medication.
• Interactions with Other Medications: Riociguat may interact with various medications, including nitrates, anticoagulants, and certain drugs metabolized by the CYP1A1 enzyme. It’s important to inform your healthcare provider about all the medications you are taking to avoid potential interactions.
• Liver and Kidney Impairment: Riociguat is metabolized in the liver, and its use may need to be adjusted in patients with liver impairment. Similarly, caution is advised in individuals with severe kidney impairment.
• Side Effects: Common side effects of riociguat may include headache, nausea, dizziness, and gastrointestinal discomfort. These side effects are generally temporary but should be reported to a healthcare professional if they persist or worsen.

It’s crucial for individuals considering or currently taking riociguat to discuss their medical history, current medications, and any concerns with their healthcare provider. Regular monitoring and communication with a healthcare professional can help manage potential risks and optimize the benefits of riociguat therapy.

Why is this medication prescribed?

Riociguat is prescribed to treat two main conditions: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).

• Pulmonary Arterial Hypertension (PAH): Riociguat is used for the treatment of PAH, a condition characterized by high blood pressure in the arteries that supply blood to the lungs. This elevated pressure can lead to symptoms such as shortness of breath, fatigue, and chest pain. Riociguat works by relaxing and dilating the blood vessels in the lungs, helping to reduce the strain on the heart and improve blood flow.
• Chronic Thromboembolic Pulmonary Hypertension (CTEPH): Riociguat is also prescribed for CTEPH, which is a type of pulmonary hypertension caused by blood clots in the lungs. In CTEPH, blood vessels in the lungs become blocked, leading to increased pressure. Riociguat helps dilate the pulmonary blood vessels and improve blood flow in this condition as well.

How should this medicine be used?

It’s important to follow the prescribed dosage and instructions provided by your healthcare provider. Here are general guidelines for using riociguat:

• Dosage: The typical starting dose of riociguat for PAH is 1 mg taken three times a day, and for CTEPH, it is 0.5 mg taken three times a day. Your healthcare provider may adjust the dosage based on your individual response.
• Administration: Riociguat is usually taken orally with or without food. It’s essential to take the medication consistently, at the same times each day.
• Missed Dose: If you miss a dose, take it as soon as you remember. However, if it’s almost time for the next dose, skip the missed dose and continue with the regular schedule. Do not double the dose to make up for a missed one.
• Interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as riociguat may interact with certain drugs.
• Monitoring: Regular follow-up appointments with your healthcare provider are essential to monitor your response to riociguat and assess for any potential side effects or complications.
• Special Considerations: Riociguat is not recommended during pregnancy due to potential harm to the fetus. Adequate contraception is advised for women of childbearing age during treatment and for at least one month after stopping the medication.

Always consult with your healthcare provider for personalized guidance on the use of riociguat, taking into account your specific medical history and individual needs. It’s important not to adjust the dosage or stop the medication without consulting your healthcare professional.

Other uses for this medicine

Riociguat is primarily approved for the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). As of last update, these are the main approved uses for riociguat. It’s essential to note that medications are typically prescribed based on the specific indications approved by regulatory agencies, and using them for other purposes may not have sufficient scientific support.

What special precautions should I follow?

As for special precautions when using riociguat, it’s crucial to follow your healthcare provider’s advice and guidelines. Here are some general precautions:

• Pregnancy and Contraception: Riociguat can cause harm to the fetus, so it is not recommended during pregnancy. Women of childbearing age should use effective contraception during riociguat treatment and for at least one month after stopping the medication.
• Liver and Kidney Function: Inform your healthcare provider about any history of liver or kidney disease. Adjustments to the dosage of riociguat may be necessary in individuals with impaired liver function.
• Blood Pressure: Riociguat can cause a drop in blood pressure, leading to symptoms like dizziness or fainting. It’s important to monitor blood pressure regularly, especially at the beginning of treatment, and inform your healthcare provider if you experience significant decreases.
• Bleeding Risk: Riociguat may increase the risk of bleeding. Inform your healthcare provider if you have a history of bleeding disorders or if you are taking anticoagulant medications.
• Drug Interactions: Riociguat can interact with various medications. Provide a comprehensive list of all the medications, supplements, and herbal products you are taking to your healthcare provider to avoid potential interactions.
• Special Populations: Special precautions may be needed for elderly individuals and those with certain medical conditions. Your healthcare provider will consider these factors when prescribing riociguat.

Always follow your healthcare provider’s instructions and attend regular follow-up appointments to monitor your response to riociguat and address any concerns or potential side effects. It’s important not to adjust the dosage or discontinue the medication without consulting your healthcare professional. If you have specific concerns or questions about riociguat, discuss them with your healthcare provider for personalized guidance based on your medical history and current health status.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with riociguat. However, it’s always a good idea to maintain a healthy and balanced diet, especially if you have conditions such as hypertension or other cardiovascular concerns. Discuss any specific dietary concerns with your healthcare provider.

What should I do if I forget a dose?

If you forget to take a dose of riociguat:

• Take it as soon as you remember: If it’s close to the time for your next scheduled dose, skip the missed dose.
• Do not double up: Do not take an extra dose to make up for the missed one.

What side effects can this medication cause?

Riociguat, like any medication, can cause side effects. It’s important to note that not everyone will experience these side effects, and some individuals may experience side effects that are not listed here. Always consult with your healthcare provider if you have concerns about potential side effects. Common side effects of riociguat include:

• Headache: Headaches are a relatively common side effect of riociguat.
• Nausea and Vomiting: Some individuals may experience nausea or vomiting while taking riociguat.
• Dizziness: Riociguat can cause dizziness, especially when standing up from a sitting or lying position. It’s important to get up slowly to minimize the risk of dizziness.
• Hypotension (Low Blood Pressure): Riociguat can lead to a decrease in blood pressure. Monitoring blood pressure regularly and reporting any symptoms of low blood pressure, such as dizziness or fainting, is crucial.
• Dyspepsia (Indigestion): Riociguat may cause indigestion or gastrointestinal discomfort.
• Diarrhea: Some individuals may experience diarrhea as a side effect.
• Nasal Congestion: Riociguat may cause nasal congestion or a stuffy nose.
• Flushing: Some individuals may experience flushing, which is a temporary reddening of the skin.
• Muscle Aches and Pains: Riociguat can cause muscle aches and pains in some individuals.
• Anemia: A decrease in hemoglobin levels, leading to anemia, may occur in some cases.

It’s important to report any persistent or severe side effects to your healthcare provider. Additionally, certain serious side effects may require immediate medical attention. These can include:

• Bleeding: Riociguat may increase the risk of bleeding. Report any signs of bleeding, such as unusual bruising or bleeding from the gums.
• Hypotension (Severe): If you experience severe dizziness or fainting, seek medical attention promptly.
• Liver Problems: Report symptoms of liver problems, such as yellowing of the skin or eyes (jaundice) or dark urine.
• Allergic Reactions: Seek immediate medical attention if you experience symptoms of a serious allergic reaction, such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or difficulty breathing.

It’s important to attend regular follow-up appointments with your healthcare provider to monitor your response to riociguat and address any concerns or side effects. Your healthcare provider can provide guidance on managing side effects and may adjust your treatment plan if necessary.

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

Storage and Disposal of Riociguat:

• Storage:
  • Store riociguat at room temperature away from light and moisture.
  • Keep the medication in its original container, and make sure it is tightly closed.
• Disposal:
  • Dispose of riociguat according to local regulations and guidelines.
  • Do not flush medications down the toilet or pour them into a drain unless specifically instructed to do so.
  • Consult with your healthcare provider or pharmacist on the appropriate disposal method for riociguat.

In case of emergency/overdose

In case of an emergency or overdose, seek medical attention immediately. Symptoms of overdose may include severe hypotension (low blood pressure), dizziness, and fainting. It’s important to contact your local poison control center or emergency room for guidance.

What other information should I know?

• Regular Follow-up: Attend all scheduled follow-up appointments with your healthcare provider to monitor your response to riociguat and adjust treatment as needed.
• Inform Healthcare Providers: Inform all healthcare providers (doctors, dentists, and pharmacists) about your use of riociguat. This includes both prescription and over-the-counter medications, as well as any supplements or herbal products.
• Contraindications: Do not take riociguat if you are pregnant or planning to become pregnant, as it can harm the fetus. Adequate contraception is essential for women of childbearing age during treatment.
• Drug Interactions: Inform your healthcare provider about all medications you are taking, as riociguat can interact with certain drugs.
• Blood Pressure Monitoring: Regularly monitor your blood pressure, especially at the beginning of treatment, and report any significant decreases to your healthcare provider.
• Avoid Alcohol and Grapefruit Juice: Limit or avoid alcohol consumption while taking riociguat. Grapefruit and grapefruit juice may interact with riociguat and should be avoided.
• Symptoms to Report: Report any unusual or persistent symptoms, side effects, or changes in your health to your healthcare provider promptly.

Always follow your healthcare provider’s instructions and guidance. If you have specific questions or concerns about riociguat, discuss them with your healthcare provider for personalized advice based on your medical history and current health status.