| Pulmonary arterial hypertension
Adcirca vs Adempass
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Adcirca vs Adempas with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsAdempas has a higher rate of injection site reactions vs Adcirca based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Adempas but not Adcirca, including UnitedHealthcare
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Category
Adcirca
Adempas
At A Glance
Oral
Daily
PDE5 inhibitor
Oral
Three times daily
Soluble guanylate cyclase (sGC) stimulator
Indications
- Pulmonary arterial hypertension
- Chronic thromboembolic pulmonary hypertension
- Pulmonary arterial hypertension
Dosing
Pulmonary arterial hypertension 40 mg (two 20 mg tablets) once daily with or without food; dividing the dose over the course of the day is not recommended. Start at 20 mg once daily for mild or moderate renal impairment (creatinine clearance 31 to 80 mL/min), increasing to 40 mg based on tolerability; avoid use in severe renal impairment. Start at 20 mg once daily for mild or moderate hepatic impairment (Child Pugh Class A or B); avoid in severe hepatic impairment. For patients on ritonavir >=1 week, start at 20 mg once daily and increase to 40 mg based on tolerability.
Chronic thromboembolic pulmonary hypertension, Pulmonary arterial hypertension Start at 1 mg three times a day (or 0.5 mg if hypotension risk); increase by 0.5 mg no sooner than every 2 weeks as tolerated, to a maximum of 2.5 mg three times a day.
Contraindications
- Concomitant use of any form of organic nitrate, regularly or intermittently
- Concomitant use of guanylate cyclase (GC) stimulators such as riociguat
- Known serious hypersensitivity to tadalafil (ADCIRCA or CIALIS), including Stevens-Johnson syndrome and exfoliative dermatitis
- Pregnancy
- Concomitant use of nitrates or nitric oxide donors in any form
- Concomitant use of PDE-5 inhibitors (sildenafil, tadalafil, or vardenafil) or nonspecific PDE inhibitors (dipyridamole or theophylline)
- Concomitant use of other soluble guanylate cyclase (sGC) stimulators
- Pulmonary hypertension associated with idiopathic interstitial pneumonias (PH-IIP)
Adverse Reactions
Most common (>=9%) Headache, myalgia, nasopharyngitis, flushing, respiratory tract infection (upper and lower), pain in extremity, nausea, back pain, dyspepsia, nasal congestion
Serious Hypotension, visual loss, hearing loss, priapism
Postmarketing Serious cardiovascular events (myocardial infarction, sudden cardiac death, stroke, chest pain, palpitations, tachycardia), hypersensitivity reactions (urticaria, Stevens-Johnson syndrome, exfoliative dermatitis), migraine, seizure, transient global amnesia, visual field defect, retinal vein occlusion, retinal artery occlusion, NAION, sudden decrease or loss of hearing, priapism
Most common (>=3%) Headache, dyspepsia and gastritis, dizziness, nausea, diarrhea, hypotension, vomiting, anemia, gastroesophageal reflux disease, constipation
Serious Embryo-fetal toxicity, hypotension, bleeding
Pharmacology
Tadalafil is a selective inhibitor of phosphodiesterase type 5 (PDE5), the enzyme responsible for degradation of cyclic guanosine monophosphate (cGMP) in pulmonary vascular smooth muscle; by inhibiting PDE5, tadalafil increases cGMP concentrations, resulting in relaxation of pulmonary vascular smooth muscle cells and vasodilation of the pulmonary vascular bed.
Riociguat is a soluble guanylate cyclase (sGC) stimulator with a dual mode of action: it sensitizes sGC to endogenous nitric oxide (NO) by stabilizing the NO-sGC binding, and directly stimulates sGC via a separate binding site independently of NO, increasing cGMP generation and leading to vasodilation.
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Most Common Insurance
Anthem BCBS
Adcirca
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (4/12) · Qty limit (11/12)
Adempas
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Adcirca
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Adempas
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Humana
Adcirca
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
Adempas
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$0/fillfill
Adcirca Co-pay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAdempas Co-pay Assistance Program
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.