| Pulmonary arterial hypertension

Opsumit vs Adcirca

Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.

Deep comparison between: Opsumit 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 Opsumit based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Adcirca but not Opsumit, including UnitedHealthcare

Category

Opsumit

Adcirca

At A Glance

RouteOral

FrequencyDaily

ClassEndothelin receptor antagonist

RouteOral

FrequencyDaily

ClassPDE5 inhibitor

Indications

Pulmonary arterial hypertension

Pulmonary arterial hypertension

Dosing

Pulmonary arterial hypertension 10 mg once daily orally; doses higher than 10 mg once daily have not been studied in patients with PAH and are not recommended.

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 (may cause fetal harm)
History of hypersensitivity reaction to macitentan or any component of the product

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

Drug Interactions

1149View drug interactions

1155View drug interactions

Adverse Reactions

Most common (>=3%) anemia, nasopharyngitis/pharyngitis, bronchitis, headache, influenza, urinary tract infection

Serious embryo-fetal toxicity, hepatotoxicity, fluid retention, decrease in hemoglobin

Postmarketing hypersensitivity reactions (angioedema, pruritus, rash), flushing, nasal congestion, liver aminotransferase elevations and liver injury, edema/fluid retention, symptomatic hypotension

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

Macitentan is an endothelin receptor antagonist that inhibits binding of ET-1 to both ETA and ETB receptors with high affinity and sustained occupancy in human pulmonary arterial smooth muscle cells; an active metabolite contributes approximately 40% of total pharmacologic activity.

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.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Opsumit