| Pulmonary arterial hypertension
Opsumit vs Revatio
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Opsumit vs Revatio 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 signalsRevatio has a higher rate of injection site reactions vs Opsumit based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Revatio but not Opsumit, including UnitedHealthcare
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Category
Opsumit
Revatio
At A Glance
Oral
Daily
Endothelin receptor antagonist
Oral or IV bolus
Three times a day
PDE-5 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 Adults: 20 mg orally three times a day (may titrate to 80 mg three times a day) or 10 mg IV bolus three times a day; pediatric patients <=20 kg: 10 mg orally three times a day; 20-45 kg: 20 mg three times a day; >45 kg: 20 mg three times a day (may titrate to 40 mg three times a day).
Contraindications
- Pregnancy (may cause fetal harm)
- History of hypersensitivity reaction to macitentan or any component of the product
- Concomitant use of organic nitrates in any form, either regularly or intermittently, due to risk of hypotension
- Concomitant use of riociguat, a guanylate cyclase stimulator
- Known hypersensitivity to sildenafil or any component of the tablet, injection, or oral suspension
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 (>=10%) Headache, flushing, pain in limb, myalgia, back pain, dyspepsia, diarrhea
Serious Hypotension, vision loss, hearing loss, priapism, vaso-occlusive crisis
Postmarketing Myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, pulmonary hemorrhage, seizure, NAION
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.
Sildenafil is a selective inhibitor of cGMP-specific PDE-5 in pulmonary vascular smooth muscle; by blocking PDE-5-mediated cGMP degradation, it elevates cGMP levels resulting in relaxation and vasodilation of the pulmonary vascular bed in patients with PAH.
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Most Common Insurance
Anthem BCBS
Opsumit
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (12/12)
Revatio
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Opsumit
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (0/8) · Qty limit (5/8)
Revatio
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Opsumit
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Revatio
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$5/fillfill
Janssen CarePath Oral PAH Savings Program: OpsumitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: MPS II- Hunter Syndrome
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.