Pulmonary hypertension:

Indications for: OPSUMIT

Treatment of pulmonary arterial hypertension (PAH, WHO Group I) to reduce disease progression risks and hospitalization for PAH.

Adult Dosage:

10mg once daily. Doses >10mg once daily: not recommended.

Children Dosage:

Not established.

OPSUMIT Contraindications:


Boxed Warning:

Embryo-fetal toxicity.

OPSUMIT Warnings/Precautions:

Embryo-fetal toxicity: in females of reproductive potential, exclude pregnancy prior to initiation, monthly during, and for 1 month after treatment discontinuation; must use acceptable methods of contraception. Obtain LFTs prior to initiation and repeat during treatment as clinically indicated. Discontinue if clinically relevant ALT/AST elevations or if elevations accompanied by bilirubin >2×ULN, or by symptoms of hepatotoxicity occur. Underlying left ventricular dysfunction: monitor for fluid retention; evaluate if develops. Severe anemia: not recommended. Measure Hgb prior to initiation and repeat during treatment as clinically indicated. Consider pulmonary veno-occlusive disease if signs of pulmonary edema occur; discontinue if confirmed. Potential decrease in sperm count; counsel men on fertility effects. Nursing mothers: not recommended.

OPSUMIT Classification:

Endothelin receptor antagonist.

OPSUMIT Interactions:

Potentiated by strong CYP3A4 inhibitors (eg, ketoconazole, ritonavir); avoid concomitant use. May be potentiated by moderate dual or combined CYP3A4 and CYP2C9 inhibitors (eg, fluconazole, amiodarone); avoid concomitant use. Antagonized by strong CYP3A4 inducers (eg, rifampin); avoid concomitant use.

Adverse Reactions:

Anemia, nasopharyngitis/pharyngitis, bronchitis, headache, influenza, urinary tract infection; hepatotoxicity, decreased hemoglobin.


For all female patients: available only through the Opsumit REMS program. To enroll call (866) 228-3546 or www.OpsumitREMS.com.


  • CYP3A4 (primarily) with minor contributions of CYP2C8, CYP2C9, and CYP2C19. 

Drug Elimination:

  • Renal (50%), fecal (24%). Half-life: ~16 hours.



Generic Drug Availability:


How Supplied:

Tabs—15, 30