Riociguat - Side Effects, Precautions, and Contraindications
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Drug Class: Commonly Known As: Category:
Soluble Guanylate Cyclase (sGC) Stimulator Adempas

Riociguat - Side Effects, Precautions, and Contraindications

What side effects can Riociguat cause?

Common side effects include:

  • Giddiness, low blood pressure, fainting
    • Rise slowly from a sitting or lying position to reduce giddiness when changing position
  • Swelling of the hands, legs, feet and ankles
  • Headache
  • Nausea, vomitting
  • Diarrhea
  • Heartburn

These side effects may be minimized by starting with a lower dose and may improve or go away with time. Inform your healthcare professional if it becomes bothersome or does not go away.

Rare side effects include: 

Very rarely, riociguat may cause abnormal bleeding. These symptoms may include one or more of the following:

  • Coughing up blood, vomiting blood/ coffee-ground like vomit
  • Vaginal bleeding
  • Frequent unexplained nose bleeds
  • Unexplained bruising on the skin

Rarely, riociguat may cause low haemoglobin (a type of protein in red blood cells) levels. These symptoms may include one or more of the following:

  • Feeling more tired/weaker than usual
  • Shortness of breath

The symptoms of a drug allergy include one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking Riociguat , what precautions must I follow?

Inform your healthcare professional if:

  • You are allergic to this medication or any of the other ingredients of this medication.
  • You are pregnant, planning to become pregnant, or breastfeeding.
    • As this medication may cause serious birth defects, female patients of childbearing age should avoid getting pregnant.
    • Avoid pregnancy by using two reliable forms of birth control during treatment, and for one month after stopping treatment with riociguat. If you have an intrauterine device, a progesterone implant or had a tubal sterilisation, these methods can be used alone and no other form of birth control is needed.
    • If you suspect you may be pregnant, inform your doctor as soon as possible.
  • You have liver or kidney problems.
  • You have a condition known as pulmonary veno-occlusive disease (narrowing of the pulmonary veins).
  • You smoke, or stop smoking during treatment.
  • You are taking any other medications, including supplements, traditional medications and herbal remedies.

What food or medicine must I avoid when I take Riociguat ?

Avoid taking grapefruit or its juice when you are taking this medication as grapefruit may interact with your medication and increase the risk of side-effects.

If you are taking riociguat, you should avoid certain medications. Some examples are: nitrates (e.g. glyceryl trinitrate, isosorbide dinitrate, isosorbide mononitrate), phosphodiesterase-5 inhibitors (e.g. sildenafil, vardenafil, tadalafil), non-specific phosphodiesterase inhibitors (e.g. theophylline, dipyridamole).

Some medications may interact with riociguat and affect its effectiveness or increase the risk of side-effects. However, these medications may also be important for your treatment. Inform your healthcare professional of the other medications you are currently taking. Examples include:

  • Medications for fungal infections (e.g. itraconazole, ketoconazole)
  • Medications for viral infections (e.g. atazanavir, darunavir, ritonavir)

Riociguat should be taken one hour apart from antacids (A type of medication used for reducing gastric acid).

Riociguat - Additional Information

  • Updated on 9/30/2020 12:00:00 AM
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup
The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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