| Pulmonary arterial hypertension
Adcirca vs Uptravi
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Adcirca vs Uptravi 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 signalsUptravi has a higher rate of injection site reactions vs Adcirca based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Uptravi but not Adcirca, including UnitedHealthcare
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Category
Adcirca
Uptravi
At A Glance
Oral
Daily
PDE5 inhibitor
Oral / IV infusion
Twice daily
Prostacyclin receptor agonist
Indications
- Pulmonary arterial 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.
Pulmonary arterial hypertension Starting dose 200 mcg orally twice daily; increase by 200 mcg twice daily at weekly intervals to the highest tolerated dose up to 1600 mcg twice daily. For moderate hepatic impairment (Child-Pugh class B), start at 200 mcg once daily and increase by 200 mcg once daily at weekly intervals. When co-administered with a moderate CYP2C8 inhibitor, reduce dosing to once daily. IV infusion (80-minute) is dosed twice daily at the corresponding tablet dose for patients temporarily unable to take oral therapy.
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
- Hypersensitivity to selexipag or any excipient
- Concomitant use of strong CYP2C8 inhibitors (e.g., gemfibrozil)
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, diarrhea, nausea, vomiting, jaw pain, myalgia, pain in extremity, flushing, arthralgia, rash, anemia, decreased appetite
Postmarketing Symptomatic hypotension
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.
Selexipag is a prostacyclin receptor (IP receptor) agonist structurally distinct from prostacyclin; it is hydrolyzed by carboxylesterase 1 to an active metabolite approximately 37-fold more potent, selective for the IP receptor over other prostanoid receptors (EP1-4, DP, FP, and TP).
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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)
Uptravi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (10/12)
UnitedHealthcare
Adcirca
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Uptravi
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Adcirca
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
Uptravi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · 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
$5/fillfill
Janssen CarePath Oral PAH Savings Program: UptraviCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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AdcircaView full Adcirca profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.