From the Research
If a patient stops taking Adempas for three days, they should restart at a lower dose to minimize the risk of hypotension and other adverse effects. The general recommendation is that if Adempas treatment is interrupted for three days or more, dose titration should be restarted at a lower dose, as supported by the study 1. This is because riociguat levels in the blood decrease relatively quickly when doses are missed, and suddenly restarting at the previous maintenance dose could potentially cause hypotension (low blood pressure) or other adverse effects. Some key points to consider when restarting Adempas after an interruption include:
- The typical approach would be to restart at 0.5 mg three times daily and gradually increase the dose under medical supervision, as riociguat works by relaxing and widening blood vessels, which directly affects blood pressure 2.
- Patients should never adjust their Adempas dosing on their own and should immediately contact their prescribing physician for specific instructions if they miss multiple doses, as individual factors may influence the appropriate restart protocol.
- The safety and efficacy of riociguat have been demonstrated in several studies, including a phase II long-term extension study 2 and a real-world switching study 1.
- It is essential to follow the recommended dose-adjustment procedure for riociguat and to be aware of the potential for adverse events, such as hypotension and hemoptysis, as reported in the study 3. Overall, the decision to restart Adempas at a lower dose after an interruption should be made on a case-by-case basis, taking into account the individual patient's circumstances and medical history, as well as the latest clinical guidelines and evidence-based recommendations 4.