Selexipag, sold under the brand name Uptravi, is a medication developed by Actelion for the treatment of pulmonary arterial hypertension (PAH). Selexipag and its active metabolite, ACT-333679 (or MRE-269, the free carboxylic acid), are agonists of the prostacyclin receptor, which leads to vasodilation in the pulmonary circulation. It is taken by mouth or administered intravenously. Contraindications
In Europe, use of selexipag together with strong inhibitors of the liver enzyme CYP2C8, such as gemfibrozil, is contraindicated because it increases concentrations of selexipag twofold, and its active metabolite 11-fold, potentially leading to more adverse effects. Adverse effects
The adverse effects of selexipag are similar to those of intravenous prostacyclins used for pulmonary arterial hypertension. Common side effects include headache and jaw pain. An increased risk for hyperthyroidism has also been noted in people taking selexipag. Pharmacology
Mechanism of action
Selexipag and its active metabolite ACT-333679 act on the prostacyclin receptor of lung tissue, with the latter being 37-fold more potent. They are selective for the prostacyclin receptor. Binding to this receptor leads to three major effects: increased vasodilation of the arteries, decreased cell proliferation and inhibition of platelet aggregation, all beneficial in the treatment of pulmonary arterial hypertension. Pharmacokinetics
Selexipag is quickly absorbed from the gut and hydrolyzed in the intestines and the liver to ACT-333679 by carboxylesterases. Absolute bioavailability is about 49%, most likely because of a high first-pass effect. Highest concentrations in the blood plasma are reached after one to three hours for selexipag and after three to four hours for the active metabolite.
Hypervitaminosis is a condition of abnormally high storage levels of vitamins, which can lead to various symptoms as over excitement, irritability, or even toxicity. Specific medical names of the different conditions are derived from the given vitamin involved: an excess of vitamin A, for example, is called hypervitaminosis A. Hypervitaminoses are primarily caused by fat-soluble vitamins  (D and A), as these are stored by the body for longer than the water-soluble vitamins.Generally, toxic levels of vitamins stem from high supplement intake and not always from natural sources but rather the mix of natural, derived vitamins and enhancers (vitamin boosters). Toxicities of fat-soluble vitamins can also be caused by a large intake of highly fortified foods, but natural food in modest levels rarely deliver extreme or dangerous levels of fat-soluble vitamins. The Dietary Reference Intake recommendations from the United States Department of Agriculture define a "tolerable upper intake level" for most vitamins. For those who are entirely healthy and do not experience long periods of avitaminosis, vitamin overdose can be avoided by not taking more than the normal or recommended amount of multi-vitamin supplement shown on the bottle and not ingesting multiple vitamin-containing supplements concurrently. Signs and symptoms
A few described symptoms:

Causes
With few exceptions, like some vitamins from B-complex, hypervitaminosis usually occurs with the fat-soluble vitamins A and D, which are stored, respectively, in the liver and fatty tissues of the body. These vitamins build up and remain for a longer time in the body than water-soluble vitamins.