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The cornerstone of drugs used to slow the progressive disease of pulmonary hypertension exhibit through these three signaling pathways including activation through nitric oxide and prostacyclin pathway and inhibition through endothelin pathway. The effect of medications has been shown by promoting the vasodilatory, inhibiting platelet aggregation, reducing endothelial cell proliferation, reducing inflammation and in situ thrombosis. The decreased in pulmonary pressure results in improved right ventricular heart pumping. These outcomes lead to improvement in patient quality of life. Selexipag is a novel oral long-acting, selective prostacyclin receptor agonist. The drug and its active metabolite showed prominent in long acting and convenient for administration. Selexipag is used for monotherapy or combination in patients receiving endothelin receptor antagonists and/or phosphodiesterase type 5 inhibitors. The results from the clinical studies have showed that selexipag is associated with the decreased composite risk of death and complications, that driven by decreased risk of hospitalization due to progressive disease. Though, the common side effects include headache, diarrhea, nausea, and jaw-pain. The monitoring of long-term adverse drug events should be aware.
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