Drug Interaction Report

GENERALLY AVOID: Concurrent administration of decongestants or vasoconstrictors may negate the vasodilatory effects of prostacyclin analogs in patients with pulmonary hypertension.

MANAGEMENT: The use of decongestants and vasoconstrictors should probably be avoided in patients with pulmonary hypertension. Patients should be counseled to consult with their physician before taking over-the-counter decongestants such as phenylephrine and pseudoephedrine.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

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. Selexipag systemic exposure (AUC) and that of its active metabolite did not significantly change, however. Selexipag may be taken with or without food. Tolerability may be improved when taken with food.