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Starting Your PAH Patients on UPTRAVI®—Setting Treatment Goals and Expectations

When you decide to start your patient on treatment with UPTRAVI®, it’s important to set goals and expectations with them.

Before starting UPTRAVI®, remind them of the following:

  • Anticipate a call from your specialty pharmacy to alert you of your next shipment of UPTRAVI®
  • Do not change your dose or stop taking UPTRAVI® unless your doctor tells you to do so1
  • Understand expectations for potential side effects. Follow up with your doctor if you have side effects that you cannot tolerate1
  • Try to take UPTRAVI® with food. This may help you tolerate the dose better if you are having side effects with UPTRAVI®1
  • After the dose adjustment phase, you will have found your personal maintenance dose of UPTRAVI®. This will be the dose you continue to take on a regular basis, unless your doctor tells you otherwise1

UPTRAVI® Dose Adjustment Phase‍—‍Helps Meet Individual Patient Needs1

Your patient's recommended starting dose is 200 mcg twice daily. UPTRAVI® dosing is unique to each patient based on how their body responds and adjusts to treatment. The dose adjustment phase is how you find your patient's personal maintenance dose.

Titrating UPTRAVI® doses mobile graphic
Tablet not shown at actual size. Tolerability may be improved when taken with food.

*Once daily for patients with moderate hepatic impairment (Child-Pugh class B) and co-administration with moderate CYP2C8 inhibitors (eg, clopidogrel, deferasirox, and teriflunomide). Increase in increments of 200 mcg once daily at weekly intervals.

  • If a dose of UPTRAVI® is missed, patients should take the missed dose as soon as possible unless the next dose is within the next 6 hours
  • If treatment is missed for 3 days or more, restart UPTRAVI® at a lower dose and then retitrate
Titrations usually occur weekly. However, slower titration may be considered to help manage some common side effects. The goal is to reach the dose that’s right for each patient, not necessarily to reach 1600 mcg.1,2

After the dose adjustment phase1

Once each patient reaches their personal dose (maintenance), a single-tablet equivalent is prescribed BID. There are 8 different single-tablet strengths of UPTRAVI®, each a unique color.

UPTRAVI® OFFERS A RANGE OF DOSE STRENGTHS TO ACCOMMODATE EACH PATIENT’s personal MAINTENANCE dose

pill-2
200 mcg Light yellow
pill-4
400 mcg Red
pill-6
600 mcg Light violet
pill-8
800 mcg Green
pill-10
1000 mcg Orange
pill-12
1200 mcg Dark violet
pill-14
1400 mcg Dark yellow
pill-16
1600 mcg Brown
Comparison of pill and dime
Size shown in relation to a dime for proportional comparison. Tablet not shown at actual size. Actual tablet size is 7 mm.

UPTRAVI® Offers Oral Administration With Similar Efficacy at Every Dose Group1

Time to first disease progression event in GRIPHON by dose group3

Percent of patients without an event across UPTRAVI® low-dose, medium-dose, high-dose, and placebo groups desktop curve

Efficacy by dose group of UPTRAVI® vs placebo3†:

  • 40% RISK
    REDUCTION
    (low dose:
    200 mcg to 400 mcg)

    HR 0.60 (95% CI: 0.41, 0.88)
  • 47% RISK
    REDUCTION
    (medium dose:
    600 mcg to 1000 mcg)

    HR 0.53 (95% CI: 0.38, 0.72)
  • 36% RISK
    REDUCTION
    (high dose:
    1200 mcg to 1600 mcg)

    HR 0.64 (95% CI: 0.49, 0.82)

UPTRAVI® doses were achieved across the 3 prespecified groups in the GRIPHON trial

  • 200 mcg to 400 mcg BID (low dose): 23% of patients (n=133)
  • 600 mcg to 1000 mcg BID (medium dose): 31% of patients (n=179)
  • 1200 mcg to 1600 mcg BID (high dose): 43% of patients (n=246)
 ORAL
ADMINISTRATION
  • Twice-daily dosing1
  • No needles, pumps, or inhalers

Not adjusted for multiplicity.

In the UPTRAVI® group, 14 patients discontinued the 200 mcg twice-daily dosage during the dose adjustment phase and 1 patient received doses different from the per protocol dosing; all 15 were assigned to 0 mcg and are not reported here.

§UPTRAVI® IV is available for patients who are temporarily unable to take oral therapy.

BID=twice daily; CI=confidence interval; GRIPHON=Prostacyclin (PGI2) Receptor Agonist In Pulmonary Arterial HypertensiON; HR=hazard ratio; IV=intravenous.

References: 1. UPTRAVI® (selexipag) full Prescribing Information. Actelion Pharmaceuticals US, Inc. 2. Kingman M, Archer‍-‍Chicko C, Bartlett M, et al. Management of prostacyclin side effects in adult patients with pulmonary arterial hypertension. Pulm Circ. 2017‍;‍7‍(‍3‍)‍:‍598‍-‍608. 3. Sitbon O, Channick R, Chin KM, et al. Selexipag for the treatment of pulmonary arterial hypertension. N Engl J Med. 2015‍;‍373‍:‍2522‍-‍2533 and suppl.