Fecha de recepción: 01/03/2018 – Fecha de aceptación: 04/06/2018
Nieves-Sedano M, Caro-Teller JM, Ferrari-Piquero JM
Servicio de Farmacia. Hospital Universitario 12 de Octubre. Madrid (España)
Marcos Nieves-Sedano w Hospital Universitario 12 de Octubre (Servicio de Farmacia) w Avenida de Córdoba, s/n w 28045 Madrid (España)
Objective: To identify and describe the pharmacological interactions between riociguat and domiciliary medications of patients with chronic thromboembolic pulmonary hypertension, and to assess their safety in clinical practice.
Method: Retrospective observational study. All patients who started treatment with riociguat before October 2017 were included. Demographic, diagnostic and therapeutic variables were collected. To assess safety, adverse reactions secondary to the treatment were recorded, the interactions detected and the reason for suspension, interruption or reduction of treatment dose were analyzed.
Results: Fifty-five patients received treatment with riociguat and the median age was 67 years (23-86). 47.27% presented some type of adverse reaction associated with the drug, highlighting: system digestive (34.55%), nervous (32.73%) and vascular (18.18%). Five patients had to reduce the dose and two had to interrupt the treatment due to side effects, highlighting a decompensation of heart failure that required admission to the emergency room. One patient presented a syncope that forced the definitive suspension of treatment.
The majority of patients presented at least one potential interaction with riociguat, registering up to 30 different interactions. The majority (n=27, 90%) of these interactions had of moderate character and the main clinical repercussion of this interaction implied an increased risk of hypotension (n=23, 76.67%).
Conclusions: 47.27% of patients experienced adverse effects during therapy with riociguat being mostly mild. The 5.45% had to interrupt or suspend the treatment, despite the high number of potential interactions found in polymedicated patients.
Key Words: Riociguat, soluble guanylyl cyclase, drug interactions, safety, polypharmacy.