Before taking riociguat,
tell your doctor and pharmacist if you are allergic to riociguat, any other medications, or any of the ingredients in riociguat tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
tell your doctor if you are taking or have recently taken a nitrate such as isosorbide dinitrate (Isordil, in BiDil), isosorbide mononitrate (Monoket), or nitroglycerin (Nitro-Dur, Nitromist, Nitrostat, Minitran, Rectiv, others),; phosphodiesterase inhibitors (PDE-5) such as avanafil (Stendra), sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), or vardenafil (Levitra, Staxyn); or if you are taking dipyridamole (Persantine, in Aggrenox), or theophylline (Theo-24, Theochron, Theolair, others). Your doctor will probably tell you not to take riociguat if you are taking this one or more of these medications. Do not take riociguat within 24 hours before or after taking sildenafil or within 24 hours before or 48 hours after taking tadalafil.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antifungals such as itraconazole (Onmel, Sporanox) and ketoconazole (Extina, Nizoral, Xolegel); HIV protease inhibitors including ritonavir (Norvir, in Kaletra); certain medications for seizures such as carbamazepine (Epitol, Equetro, Tegretol, others), phenobarbital, and phenytoin (Dilantin, Phenytek); and medications for high blood pressure. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
if you are taking antacids containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta, Tums, others), take them 1 hour before or 1 hour after taking riociguat.
tell your doctor what herbal products you are taking, especially St. John's wort.
tell your doctor if you have a pulmonary hypertension with idiopathic interstitial pneumonia (PH-IIP; lung disease). Your doctor will probably tell you not to take riociguat.
tell your doctor if you currently smoke or start or stop smoking during treatment. Also tell your doctor if you have recently had diarrhea, vomiting, or sweating a lot which may have caused dehydration (loss of a large amount of body fluids); any bleeding from your lung(s); if you have had a procedure to stop you from coughing up blood; if you have low blood pressure, pulmonary veno-occlusive disease (a blockage of veins in the lungs); or heart, kidney, or liver disease.
tell your doctor if you are breastfeeding. Do not breastfeed while you are taking riociguat.
you should know that riociguat can cause dizziness and lightheadedness. Do not drive a car or operate machinery until you know how this medication affects you.