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Do not take riociguat if you are pregnant or plan to become pregnant. Riociguat may harm the fetus. If you are sexually active and able to become pregnant, you should not begin taking riociguat until a pregnancy test has shown that you are not pregnant. You must use reliable methods of birth control during treatment and for one month after stopping riociguat. Do not have unprotected sex. Talk to your doctor about birth control methods that are effective and will work for you. Call your doctor immediately if you miss a menstrual period or think you may be pregnant while you are taking riociguat.
If you are a parent or guardian of a female who had not yet reached puberty, check your child regularly to see if she is developing any signs of puberty (breast buds, pubic hair)and let her doctor know about any changes. Your child may reach puberty before having her first menstrual period.
Because of the risk of birth defects, riociguat is available only through a special restricted distribution program. A program called Adempas Risk Evaluation and Mitigation Strategies (REMS) Program has been set up for all female patients to make sure that they are tested for pregnancy every month during treatment and for 1 month after stopping riociguat. Female patients can get riociguat only if they are registered with Adempas REMS Program. During enrollment you will choose a certified specialty pharmacy that will ship your medication to you. Ask your doctor if you have any questions about how you will receive your medication.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with riociguat and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.
Talk to your doctor about the risks of taking riociguat.
WHY is this medicine prescribed?
Riociguat is used to treat pulmonary arterial hypertension (PAH; high blood pressure in the vessels that carry blood to the lungs). Riociguat is also used to treat chronic thromboembolic pulmonary hypertension (CTEPH; high blood pressure in the lung arteries caused by blood clots that narrow or block blood flow) in adults who cannot have surgery or for those treated with surgery who continue to have high lung blood pressure levels after surgery. Riociguat may improve the ability to exercise in people with PAH and CTEPH and may slow the worsening of symptoms in people with PAH. Riociguat is in a class of medications called soluble guanylate cyclase (sGC) stimulators. It works by relaxing the blood vessels in the lungs to allow blood to flow easily.
HOW should this medicine be used?
Riociguat comes as a tablet to take by mouth. It is usually taken with or without food 3 times a day. Take riociguat at around the same time(s) every day and space your doses about 6 to 8 hours apart. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take riociguat exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you cannot swallow the tablet whole, you can crush the tablet and mix the contents with a small amount of water or a soft food such as applesauce. Swallow the mixture right after you mix it.
Your doctor may start you on a low dose of riociguat and gradually increase your dose, not more than once every 2 weeks. Your doctor may decrease your dose if you experience side effects.
Are there OTHER USES for this medication?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What SPECIAL PRECAUTIONS should I follow?
Before taking riociguat,
What SPECIAL DIETARY instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do IF I FORGET to take a dose?
Skip the missed dose and continue your regular dosing schedule. If you miss taking riociguat for more than 3 days, call your doctor. Your doctor may want to restart your medication at a lower dose.
What SIDE EFFECTS can this medicine cause?
Riociguat may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you experience any of these symptoms or those in the SPECIAL PRECAUTIONS section, call your doctor immediately or get emergency medical treatment:
Riociguat may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I do in case of OVERDOSE?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://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.
What should I know about STORAGE and DISPOSAL of this medication?
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).
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org
What OTHER INFORMATION should I know?
Keep all appointments with your doctor. Your doctor will check your blood pressure regularly during your treatment with riociguat.
Do not let anyone else take your medication.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: April 15, 2023.