What is the relationship between Selexipag (Uptravi) and fluid retention?

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Last updated: March 20, 2025View editorial policy

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From the Guidelines

Selexipag (Uptravi) is associated with fluid retention as a potential side effect, although the exact incidence and management are not explicitly stated in the provided guidelines. The medication is used to treat pulmonary arterial hypertension (PAH) and works by dilating blood vessels in the lungs, which may lead to peripheral edema (swelling in the extremities) in some patients 1. Key points to consider when evaluating the relationship between selexipag and fluid retention include:

  • The mechanism of action of selexipag as a prostacyclin receptor agonist, which can cause vasodilation and potentially increase capillary permeability, leading to fluid movement into tissues
  • The importance of monitoring for signs of fluid retention, such as sudden weight gain, puffiness, or swelling, and reporting these symptoms to a healthcare provider
  • Potential management strategies, such as reducing salt intake, elevating affected limbs, wearing compression stockings, or adding a diuretic, although specific details are not provided in the guidelines 1
  • The need for dosage adjustments if fluid retention becomes problematic, under the guidance of a healthcare provider, to avoid worsening pulmonary hypertension. In clinical practice, it is essential to weigh the benefits of selexipag in reducing morbidity and mortality in PAH patients against the potential risk of fluid retention and to closely monitor patients for signs of this side effect 1.

From the Research

Selexipag and Fluid Retention

  • There is no direct evidence in the provided studies that discusses the relationship between Selexipag (Uptravi) and fluid retention 2, 3, 4, 5, 6.
  • The studies primarily focus on the efficacy and safety of Selexipag in the treatment of pulmonary arterial hypertension (PAH), its pharmacology, and clinical outcomes 2, 3, 4, 5, 6.
  • Common adverse events reported in the studies include nausea, vomiting, diarrhea, headache, and musculoskeletal pain, but fluid retention is not specifically mentioned as an adverse event 2, 3, 4, 5, 6.

Adverse Events Associated with Selexipag

  • The adverse event profile of Selexipag is consistent with other therapies targeting the prostacyclin pathway, including headache, nausea, jaw pain, and diarrhea 3, 5.
  • Selexipag has a dose-dependent adverse-effect profile, and the recommended initial dosage is 200 μg twice daily 2.
  • The studies suggest that Selexipag is generally well tolerated, but the adverse events reported do not include fluid retention 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Selexipag for the treatment of pulmonary arterial hypertension.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2017

Research

Selexipag: A Review in Pulmonary Arterial Hypertension.

American journal of cardiovascular drugs : drugs, devices, and other interventions, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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