Uptravi (selexipag)
Selexipag is used in adults to treat pulmonary arterial hypertension (PAH, high blood pressure in the vessels that carry blood to the lungs) to slow down the worsening of symptoms and reduce the chance of being hospitalized for PAH. Uptravi (selexipag) is used for Pulmonary arterial hypertension (adults).
Pronunciation: pronunciation varies by local usage.
- Generic name
- selexipag
- Brand names
- UPTRAVI
- Drug class
- Selective nonprostanoid IP prostacyclin receptor agonist
- Form
- Film-coated tablets in strengths of 100, 150, 200, 400, 600, 800, 1,000, 1,200, 1,400 and 1,600 mcg; titration pack containing 200 mcg and 800 mcg tablets; single-dose 10 mL glass vial for injection containing 1,800 mcg of selexipag
- Route
- Oral (film-coated tablets); intravenous infusion (UPTRAVI for injection)
- Legal status
- Prescription-only medicine; not available at retail pharmacies in the United States (dispensed via a specialty pharmacy)
Availability and supply rules vary by country
Trade names by country: United States · Canada · Australia · India
Australia: Uptravi · Full directory
What selexipag is and how it works
Selexipag is used in adults to treat pulmonary arterial hypertension (PAH, high blood pressure in the vessels that carry blood to the lungs) to slow down the worsening of symptoms and reduce the chance of being hospitalized for PAH. Selexipag is in a class of medications called selective nonprostanoid IP prostacyclin receptor agonists. It works by relaxing the blood vessels in the lungs to allow blood to flow easily. (1) (2)
Selexipag controls the symptoms of PAH but does not cure it. Continue to take selexipag even if you feel well, and speak to your doctor before stopping. The dose is built up gradually over weeks and the maintenance dose is determined by tolerability. In the United States, selexipag is not available at retail pharmacies; it is mailed to the patient or to the doctor from a specialty pharmacy.
Mechanism of action: how selexipag works
Selexipag is in a class of medications called selective nonprostanoid IP prostacyclin receptor agonists. It works by relaxing the blood vessels in the lungs to allow blood to flow easily. Concomitant administration with gemfibrozil, a strong inhibitor of CYP2C8, doubled the exposure to selexipag and increased exposure to the active metabolite by approximately 11-fold. Concomitant administration with clopidogrel, a moderate inhibitor of CYP2C8, had no relevant effect on the exposure to selexipag and increased the exposure to the active metabolite by approximately 2.7-fold. Concomitant administration with rifampin, an inducer of CYP2C8 and UGT 1A3 and 2B7 enzymes, halved exposure to the active metabolite. (1)
What is Selexipag used for?
Pulmonary arterial hypertension (adults)
Selexipag is used in adults to treat pulmonary arterial hypertension (PAH, high blood pressure in the vessels that carry blood to the lungs) to slow down the worsening of symptoms and reduce the chance of being hospitalized for PAH. (2)
Pulmonary arterial hypertension (pediatric patients 2 years and older)
Safety and effectiveness of UPTRAVI have been established for the treatment of PAH in pediatric patients aged 2 years and older. Use of UPTRAVI for this indication is supported by evidence from an adequate and well-controlled study in adults with additional pharmacokinetic, pharmacodynamic, and safety data in pediatric patients aged 2 years and older (N=132). The safety and effectiveness of UPTRAVI have not been established in pediatric patients younger than 2 years. (1)
Other uses
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. (2)
Before taking selexipag
Do not take / not appropriate for
- UPTRAVI is contraindicated in patients with hypersensitivity to the active substance or to any of the excipients. (all products) (1)
- UPTRAVI is contraindicated with concomitant use of strong inhibitors of CYP2C8 (e.g., gemfibrozil). Tell your doctor if you are taking gemfibrozil; your doctor may tell you not to take selexipag if you are taking this medication. (all products) (1) (2)
Tell your clinician about
- Tell your doctor and pharmacist if you are allergic to selexipag, any other medications, or any of the ingredients in selexipag tablets. Ask your pharmacist for a list of the ingredients.
- Tell your doctor if you are taking gemfibrozil.
- Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: clopidogrel (Plavix), deferasirox (Exjade, Ferriprox, Jadenu), rifampin (Rifadin, Rimactane), and teriflunomide (Aubagio). Many other medications may also interact with selexipag, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
- Tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs), thyroid problems, or liver disease.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking selexipag, call your doctor.
Selexipag dosage and how to take it
- Selexipag comes as a tablet to take by mouth. It is usually taken with food twice a day. Take selexipag at around the same times every day.
- Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take selexipag exactly as directed.
- Your doctor will probably start you on a low dose of selexipag and gradually increase your dose, not more than once every week.
- Swallow the tablets whole. Do not split, chew, or crush them.
- Tolerability may be improved when taken with food.
- Continue to take selexipag even if you feel well. Speak to your doctor before stopping selexipag; do not stop taking selexipag without talking to your doctor.
- Do not let anyone else take your medication.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2)
Missed dose
Take the missed dose as soon as you remember it. However, if it is within 6 hours of the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you miss taking selexipag for 3 days or more, talk to your doctor before you start taking it again; you will probably have to restart taking selexipag at a lower dose.
Overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Symptoms of overdose may include nausea. Isolated cases of overdose in adults with UPTRAVI tablets up to 3,200 mcg were reported; mild, transient nausea was the only reported consequence. In the event of overdose, supportive measures must be taken as required. Dialysis is unlikely to be effective because selexipag and its active metabolite are highly protein-bound. (1) (2)
Selexipag side effects
Adverse reactions in adult and pediatric patients occurring more frequently (at least 5%) on UPTRAVI compared to placebo are headache, diarrhea, jaw pain, nausea, myalgia, vomiting, pain in extremity, and flushing. An additional adverse reaction occurring in pediatric patients more frequently (at least 5%) on UPTRAVI compared to placebo is abdominal pain. These adverse reactions are more frequent during the dose titration phase.
Headache
What to notice: Headache occurred in 65% of UPTRAVI-treated adults versus 32% on placebo in the GRIPHON study.
What to do: Tell your doctor if this symptom is severe or does not go away. (1) (2)
Diarrhea
What to notice: Diarrhea occurred in 42% of UPTRAVI-treated adults versus 18% on placebo in the GRIPHON study.
What to do: Tell your doctor if this symptom is severe or does not go away. (1) (2)
Jaw pain
What to notice: Jaw pain occurred in 26% of UPTRAVI-treated adults versus 6% on placebo in the GRIPHON study.
What to do: Tell your doctor if this symptom is severe or does not go away. (1) (2)
Nausea and vomiting
What to notice: Nausea occurred in 33% of UPTRAVI-treated adults versus 18% on placebo; vomiting occurred in 18% versus 9%. In pediatric patients, a higher frequency of vomiting was observed (39% on UPTRAVI versus 19% on placebo), and a higher frequency of vomiting and abdominal pain was observed in UPTRAVI-treated pediatric patients compared to UPTRAVI-treated adults.
What to do: Tell your doctor if this symptom is severe or does not go away. (1) (2)
Muscle, joint, and limb pain
What to notice: Myalgia occurred in 16% of UPTRAVI-treated adults versus 6% on placebo; pain in extremity occurred in 17% versus 8%; arthralgia occurred in 11% versus 8%. Pain in jaw, joints, muscles, arms, or legs is also listed in patient information.
What to do: Tell your doctor if this symptom is severe or does not go away. (1) (2)
Flushing
What to notice: Flushing occurred in 12% of UPTRAVI-treated adults versus 5% on placebo in the GRIPHON study.
What to do: Tell your doctor if this symptom is severe or does not go away. (1) (2)
Rash, decreased appetite, anemia, hyperthyroidism
What to notice: Rash occurred in 11% of UPTRAVI-treated adults versus 8% on placebo; decreased appetite in 6% versus 3%; anemia in 8% versus 5% (adverse reactions more frequent on UPTRAVI than placebo by at least 3%). Hyperthyroidism was observed in 1% (n=8) of patients on UPTRAVI tablets and in none of the patients on placebo.
What to do: Tell your doctor if this symptom is severe or does not go away. (1)
Shortness of breath, rapid breathing, dizziness, or weakness
What to notice: Shortness of breath, rapid breathing, dizziness, weakness.
What to do: Call your doctor immediately or get emergency medical treatment. (2)
Signs of pulmonary edema in pulmonary veno-occlusive disease
What to notice: Should signs of pulmonary edema occur, consider the possibility of associated pulmonary veno-occlusive disease.
What to do: Seek medical assessment; if pulmonary veno-occlusive disease is confirmed, treatment is discontinued. Let the clinician you see advise on whether to continue or stop. (1)
Serious warnings
Pulmonary edema with pulmonary veno-occlusive disease — serious
Symptoms: Signs of pulmonary edema.
Action: Should signs of pulmonary edema occur, consider the possibility of associated pulmonary veno-occlusive disease. If confirmed, discontinue UPTRAVI. Seek medical attention promptly and let the clinician you see advise on whether to continue or stop. (1)
Serious side effects requiring immediate medical attention — urgent
Symptoms: Shortness of breath, rapid breathing, dizziness, weakness.
Action: Call your doctor immediately or get emergency medical treatment. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Strong CYP2C8 inhibitors (e.g., gemfibrozil) | Concomitant administration with gemfibrozil, a strong inhibitor of CYP2C8, doubled the exposure to selexipag and increased exposure to the active metabolite by approximately 11-fold. Concomitant use with strong inhibitors of CYP2C8 is contraindicated. | Tell your doctor if you are taking gemfibrozil. Your doctor may tell you not to take selexipag if you are taking this medication. (1) (2) |
| Moderate CYP2C8 inhibitors (e.g., clopidogrel, deferasirox, teriflunomide) | Concomitant administration of UPTRAVI tablets with clopidogrel, a moderate inhibitor of CYP2C8, had no relevant effect on the exposure to selexipag and increased the exposure to the active metabolite by approximately 2.7-fold. Moderate CYP2C8 inhibitors increase exposure to the active metabolite of UPTRAVI. | Reduce the dosing of UPTRAVI to once daily in adult and pediatric patients on a moderate CYP2C8 inhibitor. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. (1) (2) |
| CYP2C8 inducers (e.g., rifampin) | Concomitant administration with an inducer of CYP2C8 and UGT 1A3 and 2B7 enzymes (rifampin) halved exposure to the active metabolite. CYP2C8 inducers decrease exposure to the active metabolite. | Increase UPTRAVI up to twice the dose when co-administered with rifampin. Reduce UPTRAVI when rifampin is stopped. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. (1) (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Children and adolescents
Safety and effectiveness of UPTRAVI have been established for the treatment of PAH in pediatric patients aged 2 years and older. UPTRAVI-treated pediatric patients experienced a smaller mean increase in body weight and height compared to placebo; when treating pediatric patients with UPTRAVI, monitor growth. A higher frequency of vomiting and abdominal pain was observed in UPTRAVI-treated pediatric patients compared to UPTRAVI-treated adults. The safety and effectiveness of UPTRAVI have not been established in pediatric patients younger than 2 years; due to nonclinical studies demonstrating a risk of intussusception in juvenile dogs and known susceptibility to gastrointestinal intussusception in young children, treatment with UPTRAVI in pediatric patients younger than 2 years of age was not studied. (1)
Pregnancy
There are no adequate and well-controlled studies with UPTRAVI in pregnant women. Animal reproduction studies performed with selexipag showed no clinically relevant effects on embryofetal development and survival; a slight reduction in maternal as well as in fetal body weight was observed in rats at a high dose, and no adverse developmental outcomes were observed in rabbits. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. In patients with pulmonary arterial hypertension, pregnancy is associated with an increased rate of maternal and fetal morbidity and mortality, including heart failure, stroke, spontaneous abortion, intrauterine growth restriction, premature labor, and preterm birth. Tell your doctor if you are pregnant, plan to become pregnant, or become pregnant while taking selexipag. (1) (2)
Breastfeeding
It is not known if UPTRAVI is present in human milk. Selexipag or its metabolites were present in the milk of rats. Because many drugs are present in human milk and because of the potential for serious adverse reactions in nursing infants, discontinue nursing or discontinue UPTRAVI. Tell your doctor if you are breastfeeding. (1) (2)
Moderate hepatic impairment
For moderate hepatic impairment, the starting dose is once daily, increased in increments of the starting dose once daily at weekly intervals to the maximum allowed or highest tolerated dose. Tell your doctor if you have or have ever had liver disease. (1) (2)
Thyroid problems
Tell your doctor if you have or have ever had thyroid problems. Hyperthyroidism was observed in 1% (n=8) of patients on UPTRAVI tablets and in none of the patients on placebo. (1) (2)
Monitoring
Before starting
- Confirm whether the patient is taking gemfibrozil or any other strong CYP2C8 inhibitor, which is contraindicated with UPTRAVI.
- Review all prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products, including clopidogrel, deferasirox, rifampin, and teriflunomide.
- Assess for hypersensitivity to selexipag or any of the ingredients in selexipag tablets.
- Assess for a history of pulmonary veno-occlusive disease, thyroid problems, or liver disease.
- Establish pregnancy and breastfeeding status.
During treatment
- Titrate the dose gradually, usually at weekly intervals, to the highest tolerated dose; the maintenance dose is determined by tolerability.
- Monitor for adverse reactions, which are more frequent during the dose titration phase.
- Monitor for signs of pulmonary edema and consider the possibility of associated pulmonary veno-occlusive disease.
- Monitor growth in pediatric patients; UPTRAVI-treated pediatric patients experienced a smaller mean increase in body weight and height compared to placebo.
- Re-evaluate further dose titration based on changes in body weight category over time in pediatric patients.
- Monitor for thyroid effects (hyperthyroidism was observed in 1% of patients on UPTRAVI tablets and in none on placebo).
Storage
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). UPTRAVI tablets: store at 20 °C to 25 °C (68 °F to 77 °F); excursions are permitted between 15 °C and 30 °C (59 °F and 86 °F). Recommended storage for UPTRAVI 100 mcg and 150 mcg tablets: store and dispense in the original package to protect from moisture. UPTRAVI for injection: store the original carton containing the glass vial in a refrigerator at 2 °C to 8 °C (36 °F to 46 °F) until use in order to protect from light.
Professional information
Clinician-facing context only. Use the current local prescribing information, dosing tables, preparation and administration instructions, and background-disease guideline.
United States
Indication: Pulmonary arterial hypertension — adults (UPTRAVI film-coated tablets)
Dose summary: Starting dosage 200 mcg orally twice daily. Increase in increments of 200 mcg orally twice daily, usually at weekly intervals, to the highest tolerated dose up to 1,600 mcg orally twice daily. If a patient reaches a dose that cannot be tolerated, reduce to the previous tolerated dose. Tolerability may be improved when taken with food. Swallow tablets whole; do not split or crush.
Renal context: Not established by the supplied research notes. (1)
United States
Indication: Pulmonary arterial hypertension — pediatric patients 2 years and older (UPTRAVI film-coated tablets)
Dose summary: Starting dose is determined by body weight and given orally twice daily. 9 kg to less than 25 kg: starting dose 100 mcg twice daily, titration increments 100 mcg twice daily, maximum 800 mcg twice daily. 25 kg to less than 40 kg: starting dose 150 mcg twice daily, titration increments 150 mcg twice daily, maximum 1,200 mcg twice daily. 40 kg to less than 50 kg: starting dose 150 mcg twice daily, titration increments 150 mcg twice daily, maximum 1,600 mcg twice daily. 50 kg and greater: starting dose 200 mcg twice daily, titration increments 200 mcg twice daily, maximum 1,600 mcg twice daily. Increase the dose in increments equivalent to the starting dose at weekly intervals to the highest tolerated dose up to the maximum allowed for the patient's body weight. If a patient reaches a dose that cannot be tolerated or medically managed, reduce to the previous tolerated dose. Re-evaluate further dose titration based on changes in body weight category over time.
Renal context: Not established by the supplied research notes. (1)
United States
Indication: Moderate hepatic impairment (UPTRAVI film-coated tablets)
Dose summary: Starting dose once daily; increase in increments of the starting dose once daily at weekly intervals to the maximum allowed or highest tolerated dose.
Renal context: Not established by the supplied research notes. (1)
United States
Indication: Pulmonary arterial hypertension (UPTRAVI for injection)
Dose summary: Dose is determined by the patient's current dose of UPTRAVI tablets. Administer by intravenous infusion, twice daily. See the Full Prescribing Information for instructions on preparation and administration.
Renal context: Not established by the supplied research notes. (1)
Hepatic guidance
In moderate hepatic impairment, the starting dose is once daily, increased in increments of the starting dose once daily at weekly intervals to the maximum allowed or highest tolerated dose. No further impairment-specific dosing is established by the supplied research notes.
Overdose note
Isolated cases of overdose in adults with UPTRAVI tablets up to 3,200 mcg were reported; mild, transient nausea was the only reported consequence. In the event of overdose, supportive measures must be taken as required. Dialysis is unlikely to be effective because selexipag and its active metabolite are highly protein-bound. (1)
Frequently asked questions
Does selexipag cure pulmonary arterial hypertension?
No. Selexipag controls the symptoms of PAH but does not cure it. Continue to take selexipag even if you feel well, and speak to your doctor before stopping. (2)
Can I take selexipag with gemfibrozil?
Concomitant use of UPTRAVI with strong inhibitors of CYP2C8 such as gemfibrozil is contraindicated. Tell your doctor if you are taking gemfibrozil; your doctor may tell you not to take selexipag if you are taking this medication. (1) (2)
Can I split or crush the tablets?
No. Swallow the UPTRAVI tablets whole. Do not split or crush the tablets. For patients who cannot swallow tablets whole, 100 mcg or 150 mcg tablets can be dispersed in apple or orange juice or given with soft foods such as yogurt, applesauce, or mashed banana, following the label instructions. (1) (2)
What should I do if I miss a dose?
Take the missed dose as soon as you remember it. However, if it is within 6 hours of the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you miss taking selexipag for 3 days or more, talk to your doctor before you start taking it again; you will probably have to restart at a lower dose. (2)
Where can I get selexipag?
Selexipag is not available at retail pharmacies. Your medication will be mailed to you or to your doctor from a specialty pharmacy. Ask your doctor if you have any questions about how you will receive your medication. (2)
What is the mechanism of action of selexipag?
Selexipag is in a class of medications called selective nonprostanoid IP prostacyclin receptor agonists. It works by relaxing the blood vessels in the lungs to allow blood to flow easily. Concomitant administration with gemfibrozil, a strong inhibitor of CYP2C8, doubled the exposure to selexipag and increased exposure to the active metabolite by approximately 11-fold. Concomitant administration with clopidogrel, a moderate inhibitor of CYP2C8, had no relevant effect on the exposure to selexipag and increased the exposure to the active metabolite by approximately 2.7-fold. Concomitant administration with rifampin, an inducer of CYP2C8 and UGT 1A3 and 2B7 enzymes, halved exposure to the active metabolite. (1)
References
- UPTRAVI (selexipag) — full prescribing information, Actelion/JanssenDailyMed, U.S. National Library of Medicine (FDA label) · United States · accessed 2026-10-13 · source 1
- Selexipag: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-10-13 · source 2
Brand names by country
Single-ingredient selexipag names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- UPTRAVItablet, coated, tablet, film coated, injection, powder, for solution · 1400 ug, 400 ug, 1000 ug, 150 ug, 200 ug, 800 ug, 100 ug, 600 ug · actelion pharmaceuticals us, inc.regulator source
Canada
- UPTRAVIregulator source
Australia
- Uptravireference source
India
Source-listed products; local stock and regulatory approval have not been confirmed. Check the exact ingredient, strength, and formulation with a pharmacist.
- Selepeg 200 TabletTablet · 200mg · MSN Laboratoriespharmacy source recorded · checked 2026-09-24