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Overview: Adempas is a tablet that is used to treat certain types of pulmonary hypertension. It helps lower blood pressure in the lungs. Common side effects include headaches, dizziness, and an upset stomach. Serious side effects may include bleeding and low blood pressure.

Uses

What is Adempas used for?

Adempas (riociguat) is commonly used for pulmonary arterial hypertension (PAH), a condition where you have high pressure in the blood vessels that carry blood into your lungs. Over time, this pressure can strain your heart and make it harder for you to breathe and be physically active.

Adempas is also commonly used for certain people with chronic thromboembolic pulmonary hypertension (CTEPH), a condition where you have high blood pressure in the lungs after having a blood clot in your lungs. 

Adempas may also be used for other conditions as determined by your health care provider.

How does Adempas work (mechanism of action)?

Adempas turns on a protein in your body called soluble guanylate cyclase (sGC). This helps relax the blood vessels and lowers blood pressure in the lungs, which may help improve symptoms. 

How is Adempas supplied (dosage forms)?

Brands and other names

  • Adempas

Dosage forms and strengths

  • 0.5 mg oral tablets
  • 1 mg oral tablets
  • 1.5 mg oral tablets
  • 2 mg oral tablets
  • 2.5 mg oral tablets

How should I store Adempas?

Adempas should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when you’re transporting it. Store it in a cool, dry place.

Side Effects

What are the most common side effects of Adempas?

The most common side effects of Adempas are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Indigestion or acid reflux
  • Dizziness
  • Nausea or vomiting
  • Diarrhea
  • Fluid buildup in your hands, legs, feet, and ankles
  • Low blood pressure (see below)
  • Low levels of red blood cells (anemia)
  • Constipation

There may be other side effects of Adempas that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Adempas?

While less common, the most serious side effects of Adempas are described below, along with what to do if they happen.

Severe Allergic Reactions. Adempas may cause allergic reactions, which can be serious. Stop taking Adempas and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Bleeding. People taking Adempas may have an increased risk of bleeding. Tell your health care provider if you notice any changes in how easily you bruise or bleed. Get help right away if you are coughing up blood, vomiting blood, or have any bleeding that does not stop.

Low Blood Pressure (Hypotension). Adempas may cause low blood pressure. The risk may be higher if you are dehydrated or have certain heart or other health problems. Keep all appointments, including for blood pressure checks, while taking Adempas. Your health care provider may recommend checking your blood pressure at home while taking Adempas. If you feel faint or dizzy, lie down. Tell your health care provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

Warnings & Precautions

Who should not take Adempas?

Allergies to Ingredients. People who are allergic to any of the following should not take Adempas.

  • Adempas
  • Riociguat
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Adempas.

Drug Interactions. Adempas should not be taken while you are taking certain other medicines. Before taking Adempas, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Do not take Adempas if you are pregnant or plan to become pregnant. If you become pregnant or think you might be pregnant, contact your health care provider right away. See the Pregnancy section for more details.

Interstitial Pneumonia. Do not take Adempas if you have pulmonary hypertension that is related to interstitial pneumonia. Having this condition can make it unsafe to take Adempas due to the risk of side effects.

What should I know about Adempas before taking it?

Do not take Adempas unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Adempas with other people, even if they have the same condition as you. It may harm them.

Keep Adempas out of the reach of children.

Adempas can cause dizziness. Do not drive or do other activities that require alertness or coordination until you know how Adempas affects you. Tell your health care provider if you have dizziness that is getting worse while taking Adempas.

If you have trouble swallowing Adempas whole, you can crush the tablet and mix it with water or a soft food, such as applesauce. Take this mixture right away.

Adempas may cause indigestion or heartburn, but it can interact with antacids. If you take any antacid medicine, take it at least one hour before or after taking Adempas. Ask your pharmacist if you have any questions.

For females (people assigned female at birth), Adempas is only available through a special program and from certain pharmacies. It is important that you follow the program’s birth control requirements and keep all of your appointments, including labs or other testing, while taking Adempas. If you have any questions about this program, you can go to www.AdempasREMS.com or call 855-423-3672. People assigned male at birth are not required to enroll in this program.

What should I tell my health care provider before taking Adempas?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Adempas is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Kidney problems or dialysis
  • Low blood pressure
  • Heart or blood vessel problems
  • Recent severe bleeding from your lungs or coughing up blood (hemoptysis)
  • Pulmonary veno-occlusive disease, a condition where blood vessels in the lungs are blocked or narrowed

Smoking. Smoking can affect how well Adempas works. Tell your health care provider if you smoke or if you start or stop smoking while taking Adempas. They may need to change your dosage.

Pregnancy. Adempas may harm an unborn baby. You must not be pregnant before starting and while taking Adempas. If you can become pregnant, you must use highly effective birth control (such as two forms of birth control) while taking Adempas and for at least one month after your last dose. Talk to your health care provider about your birth control options. If you become pregnant or think you might be pregnant, contact your health care provider right away.

Breastfeeding. Do not breastfeed while you are taking Adempas. It is not known if Adempas passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Adempas?

For more information about Adempas, you can visit the drugmaker’s website at www.adempas-us.com or call them at 888-842-2937.

Interactions

Does Adempas interact with foods or drinks?

Your health care provider may recommend limiting or avoiding grapefruit while taking Adempas. Eating grapefruit or drinking grapefruit juice may raise blood levels of the medicine in your body, which could increase the risk of side effects.

It is unknown if drinking alcohol will affect Adempas, but both Adempas and alcohol can increase your risk of dizziness or bleeding. It is best to limit the amount of alcohol you drink.

Does Adempas interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Adempas.

  • ​​Any other type of medicine called a soluble guanylate cyclase (sGC) stimulator, such as vericiguat (Verquvo)
  • A nitrate, such as nitroglycerin (Nitro-Dur, NitroMist, Nitrostat, and others), isosorbide dinitrate (Isordil), or isosorbide mononitrate, which is a medicine used to prevent or treat short-lasting chest pain caused by a type of heart disease, or a street drug, such as amyl nitrite ("poppers")
  • A phosphodiesterase-5 (PDE-5) inhibitor, such as avanafil (Stendra), sildenafil (Revatio, Viagra, and others), tadalafil (Cialis and others), or vardenafil (Levitra, Staxyn), which is a medicine used for erectile dysfunction or pulmonary arterial hypertension (PAH)
  • Any other medicine used for erectile dysfunction or pulmonary arterial hypertension
  • An antacid, supplement, or laxative containing aluminum or magnesium
  • Theophylline (Elixophyllin, Theo-24), which is a medicine for asthma or certain other breathing problems
  • A medicine for high blood pressure
  • Itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are medicines used for fungal infections
  • A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIV
  • Any medicine for seizures, such as carbamazepine, phenobarbital, or phenytoin
  • Dipyridamole, which is a medicine used to prevent blood clots
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • St. John’s wort, which is a supplement that may be used for depression

Many other medicines may alter the blood levels of Adempas. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Adempas. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Adempas?

If you or someone else has used too much Adempas, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Adempas?

If you miss a dose, skip the missed dose and only take the next dose at the regular time. Do not take double or extra doses. If you miss taking Adempas for three or more days in a row, call your health care provider for advice.