About riociguat
Soluble guanylate cyclase stimulator
Used for
- Treats pulmonary arterial hypertension in adults and some children.
- Treats persistent or recurrent chronic thromboembolic pulmonary hypertension after surgery, or inoperable disease.
Usual adult dose
Usually starts at 1 mg three times daily, adjusted every two weeks up to 2.5 mg three times daily; lower starting dose may be used when blood pressure is low or medicines increase exposure.
Usual dose in children
For pulmonary arterial hypertension in children aged 6 years and older, dosing is weight-based and adjusted by a specialist.
Common side effects
- Headache, dizziness, indigestion, nausea, or diarrhea
- Low blood pressure or fainting
- Anemia
- Bleeding, including nosebleeds
Important warnings
- Must not be used during pregnancy; pregnancy testing and prevention are required for those who could become pregnant.
- Avoid nitrates, nitric oxide donors, and PDE-5 inhibitors because blood pressure may fall dangerously.
- Do not use with strong CYP/P-glycoprotein or BCRP inhibitors; smoking can reduce effectiveness.
- May cause serious bleeding; monitor for worsening breathing or low blood pressure.
Pregnancy
Can harm the fetus. Contraindicated during pregnancy; effective contraception and regular pregnancy testing are required for those who could become pregnant.
Breastfeeding
Breastfeeding is not recommended during treatment because effects on the infant are unknown.
Interactions
- Nitrates, nitric oxide donors, sildenafil, tadalafil, and other PDE-5 inhibitors
- Strong CYP3A, P-glycoprotein, or BCRP inhibitors, such as ketoconazole
- Antacids containing aluminum or magnesium can reduce absorption; separate doses by one hour.
- Smoking may reduce medicine levels and effectiveness.
AI-generated from general medical knowledge, not from this product's official leaflet. It may be incomplete or out of date. Not medical advice — ask a pharmacist or doctor before making any decision.