Initial dose: 200 mcg orally twice a day
Maintenance dose: Increase in increments of 200 mcg orally twice a day at weekly intervals to the highest tolerated dose
Maximum dose: 1600 mcg orally twice a day
Comment:
If the patient reaches a dose that is not well tolerated, reduce to a previously tolerated dose.
Use: For the treatment of pulmonary arterial hypertension (PAH) to delay disease progression and reduce the risk of hospitalization for PAH
Renal Dose Adjustments
Estimated GFR (eGFR) greater than 15 mL/min/1.73 m2: No adjustment recommended.
eGFR less than 15 mL/min/ 1.73 m2: Data not available
Liver Dose Adjustments
Mild liver dysfunction (Child-Pugh A): No adjustment recommended.
Moderate liver dysfunction (Child-Pugh B): 200 mcg orally once a day; increase in increments of 200 mcg orally once a day at weekly intervals as tolerated.
Severe liver dysfunction (Child-Pugh C): Not recommended.
Precautions
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
Do not split, crush, or chew.
Tolerability may be improved when taken with food.
If a dose is missed, take the next dose as soon as possible unless the next dose is within the next 6 hours.
If treatment is missed for 3 days or more, restart at lower dose and then retitrate.
