Transitioning between prostacyclin therapies
Two patients were prescribed triple combination therapy at baseline,
including inhaled iloprost at doses of 5 μg six times a day. In both
cases when selexipag was initiated at 200 μg twice daily, iloprost was
simultaneously reduced to 5 μg four times a day by excluding the morning
and the evening iloprost doses. Iloprost was then reduced to 5 μg twice
daily in the second week, when selexipag was increased to 400 μg twice
daily. This was well tolerated and inhaled iloprost was discontinued by
week 3, with ongoing up titration of selexipag until individual
maintenance doses were achieved. Final doses of 1200 μg twice daily and
1400 μg twice daily were achieved in these cases, which was
significantly higher when compared to doses achieved by other patients
in our centre. (p=0.037)