| Pulmonary arterial hypertension
Adempass vs Adcirca
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Adempas vs Adcirca 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 signalsAdcirca has a higher rate of injection site reactions vs Adempas based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Adcirca but not Adempas, including UnitedHealthcare
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Category
Adempas
Adcirca
At A Glance
Oral
Three times daily
Soluble guanylate cyclase (sGC) stimulator
Oral
Daily
PDE5 inhibitor
Indications
- Chronic thromboembolic pulmonary hypertension
- Pulmonary arterial hypertension
- Pulmonary arterial hypertension
Dosing
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.
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.
Contraindications
- 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)
- 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
Adverse Reactions
Most common (>=3%) Headache, dyspepsia and gastritis, dizziness, nausea, diarrhea, hypotension, vomiting, anemia, gastroesophageal reflux disease, constipation
Serious Embryo-fetal toxicity, hypotension, bleeding
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
Pharmacology
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.
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.
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Most Common Insurance
Anthem BCBS
Adempas
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Adcirca
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (4/12) · Qty limit (11/12)
UnitedHealthcare
Adempas
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Adcirca
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Adempas
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Adcirca
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAdempas Co-pay Assistance Program
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$0/fillfill
Adcirca Co-pay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.