FDA-filed SPL labeling · retrieved through openFDA

Sotatercept-Csrk

Sotatercept-csrk (WINREVAIR) is a prescription injection used to treat pulmonary arterial hypertension (PAH) in adults, helping improve exercise ability, functional status, and reducing the risk of serious disease worsening.

Brand name Winrevair
Rx Forms 2 Route Injection
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Sep 2, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveAug 12, 2026
AvailabilityRx
Earliest approval/marketing year 2024
FDA-listed product records 24
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Sotatercept-Csrk at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
WINREVAIR (sotatercept-csrk) is a first-in-class subcutaneous injection that treats pulmonary arterial hypertension by rebalancing signals that cause abnormal blood vessel growth in the lungs. It is used alongside other PAH medications to help patients breathe and move better and to lower the risk of serious complications. Close monitoring of blood counts is essential throughout treatment, and women of childbearing age must use effective contraception while taking it.

📖 Sotatercept-Csrk: Patient Information Guide

A plain-language walkthrough of Sotatercept-Csrk — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Sotatercept-csrk is approved for use in adults with pulmonary arterial hypertension (PAH). All current FDA-supported uses are specific to WINREVAIR, the branded product.

  • WINREVAIR is indicated for the treatment of adults with pulmonary arterial hypertension (PAH, WHO Group 1 pulmonary hypertension) to improve exercise capacity and WHO functional class
  • WINREVAIR reduces the risk of clinical worsening events, including hospitalization for PAH, lung transplantation, and death
  • WINREVAIR is used in combination with background standard-of-care PAH therapies, not as a standalone replacement
⚙️How it works

In pulmonary arterial hypertension, the small blood vessels in the lungs become abnormally narrow because cells in the vessel walls grow and multiply too much. WINREVAIR (sotatercept-csrk) is a fusion protein — a specially engineered molecule — that acts as a trap for activin A and related signaling proteins called TGF-β superfamily ligands. By binding these proteins, it quiets the pathway that drives excess cell growth and inflammation, and lets the opposing pathway that normally restrains vessel-wall thickening work properly again. In animal models, this led to thinner vessel walls, partial recovery of the right side of the heart, and better blood flow through the lungs.

💊How it's taken

WINREVAIR is given as a subcutaneous injection (a shot under the skin) once every three weeks. Treatment starts at a lower dose and is increased to the target dose over time, based on how your hemoglobin and platelet counts respond.

  • Blood counts are checked before each of the first five doses — or longer if levels are not stable
  • Doses may be delayed or reduced if hemoglobin rises too high or platelets fall too low
  • There are no food restrictions associated with WINREVAIR
  • Follow your prescriber's exact schedule — do not adjust your dose on your own
🤒Side effects — in detail

The most common side effects reported in clinical trials of WINREVAIR include:

  • Nosebleeds (epistaxis)
  • Headache
  • Rash
  • Telangiectasia (small, visible dilated blood vessels on the skin) — typically appearing after several months of treatment
  • Diarrhea
  • Dizziness
  • Skin redness (erythema)
  • Gum bleeding (gingival bleeding)

More serious reactions include a significant rise in red blood cell count (erythrocytosis), a dangerous drop in platelet count (severe thrombocytopenia), and serious bleeding events — contact your doctor right away if you notice signs of unusual bleeding, blood clots, or a very high blood pressure reading.

⚠️Warnings & precautions
  • Erythrocytosis (too many red blood cells): WINREVAIR can raise hemoglobin levels. If levels get very high, the blood becomes too thick, raising the risk of blood clots and a condition called hyperviscosity syndrome. Regular blood monitoring is used to catch this early and adjust your dose if needed.
  • Severe thrombocytopenia (very low platelets): WINREVAIR can lower platelet counts, which increases bleeding risk. Platelet counts are monitored closely, especially in the first several doses.
  • Serious bleeding: Serious bleeding events have occurred, and the risk is higher in patients also taking prostacyclin therapies or blood thinners, or who have low platelet counts. WINREVAIR must not be given during active serious bleeding.
  • Fetal harm (embryo-fetal toxicity): Animal studies show WINREVAIR can cause harm to a developing baby, including pregnancy loss and growth problems. Women who can become pregnant must use effective contraception during treatment and for at least 4 months after the last dose.
  • Fertility: WINREVAIR may affect fertility in both women and men — discuss family planning with your doctor before starting treatment.
🔀What it interacts with

The FDA label for WINREVAIR identifies two key drug interaction concerns to discuss with your healthcare team:

  • Prostacyclin therapies (medications commonly used to treat PAH, such as epoprostenol or treprostinil) — when combined with WINREVAIR, the risk of serious bleeding is increased
  • Antithrombotic agents (blood thinners and antiplatelet drugs) — using these alongside WINREVAIR raises the risk of serious bleeding, especially if platelet counts are already low

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Pregnancy: WINREVAIR can harm a developing baby. A pregnancy test is recommended before starting, and effective contraception must be used during treatment and for at least 4 months after the final dose.
  • Breastfeeding: Breastfeeding is not recommended during WINREVAIR treatment or for 4 months after the last dose, because the potential effects on an infant are unknown.
  • Low platelet count: Treatment should not be started if your platelet count is below the safe threshold — your doctor will check this before your first dose.
  • Fertility concerns: WINREVAIR may impair fertility in both men and women. Discuss this with your doctor before beginning treatment if having children is a consideration.
  • Children: The safety and effectiveness of WINREVAIR have not been established in patients under 18 years of age.
  • Older adults: Patients 65 and older were included in clinical studies without differences in effectiveness observed. Always share your complete health history with your prescriber.
  • Kidney disease: No significant differences in drug behavior were seen in patients with mild to moderate kidney disease or end-stage kidney disease, but discuss your kidney health with your doctor.
🚑If you take too much

In studies of healthy volunteers, taking too much WINREVAIR caused hemoglobin to rise and blood pressure to increase; both improved with a procedure called phlebotomy (removing blood). If an overdose is suspected, medical monitoring of hemoglobin and blood pressure is recommended, along with supportive care. WINREVAIR cannot be removed from the body by dialysis.

📡Pharmacodynamics — effects in the body

In clinical trials, WINREVAIR significantly reduced pulmonary vascular resistance (PVR) — a measure of how hard the heart has to work to push blood through the lungs — compared to placebo. It also substantially lowered NT-proBNP, a blood marker of heart strain. In the highest-risk patients studied (ZENITH trial), WINREVAIR additionally reduced mean pulmonary artery pressure by a clinically meaningful amount. These changes reflect real improvements in how blood flows through the lungs and how much stress the heart is under.

🔬Pharmacokinetics — how your body processes it

WINREVAIR is given as a subcutaneous (under-the-skin) injection and reaches peak blood levels roughly 7 days after each dose, with about 66% of the drug absorbed into the bloodstream. It stays in the body for a long time — its effective half-life (the time it takes the body to clear half the drug) is approximately 24 days, so it takes about 15 weeks of regular dosing to reach stable, steady levels. The drug is broken down into small peptides by the body's normal protein-clearing pathways and is not significantly affected by age, sex, race, or kidney disease.

📦How to store it

Store vials refrigerated at 2°C to 8°C (36°F to 46°F) in original carton to protect from light. Do not freeze. refrigerator until ready for use.

📄 Written from Sotatercept-Csrk’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Sotatercept-Csrk — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is WINREVAIR and why has my doctor prescribed it?
WINREVAIR is the brand name for sotatercept-csrk, an injection used specifically for pulmonary arterial hypertension — that's high blood pressure in the arteries going to your lungs. It works differently from most other PAH medications by correcting an imbalance in the signals that control how lung blood vessel walls grow. Your doctor prescribed it to help you breathe and exercise better, and to lower the chance of serious problems like hospitalization or worsening of your PAH. It's used alongside, not instead of, your other PAH medications.
How is this medication given, and how often will I need it?
WINREVAIR is given as a shot under the skin — similar to how some diabetes medications are given — once every three weeks. You'll start on a lower amount, and your doctor will increase it to the full target dose over time based on your blood test results. Before your first several doses, you'll have blood drawn to check your red blood cell levels and platelet count, so your care team can make sure the dose is right for you. Stick to the schedule your prescriber sets — don't adjust it on your own.
What side effects should I watch out for?
The most common ones include nosebleeds, headache, rash, dizziness, diarrhea, and skin redness. You may also notice small dilated blood vessels on your skin (called telangiectasia) after several months — this is recognized and your doctor will be aware of it. More importantly, call your doctor right away if you have unusual or heavy bleeding anywhere, signs of a blood clot (sudden chest pain, shortness of breath, or leg swelling), or a significant spike in blood pressure. These can be signs of more serious effects that need prompt attention.
I'm a woman of childbearing age — what do I need to know?
This is really important: WINREVAIR can harm a developing baby, so your doctor will do a pregnancy test before starting treatment. You must use effective birth control while on WINREVAIR and for at least 4 months after your last dose. Breastfeeding is also not recommended during treatment and for 4 months after stopping. If you think you might be pregnant at any point during treatment, contact your doctor right away. And if you're thinking about having children in the future, have that conversation with your doctor before starting — the medication may also affect fertility.
Why do I need so many blood tests while on this medication?
WINREVAIR can raise your red blood cell count (hemoglobin) and lower your platelet count, and both of those changes can cause problems if they go too far. Very high red blood cell levels can thicken your blood and raise clot risk; very low platelets can raise bleeding risk. Checking your blood before each of your first five doses — and periodically after that — lets your doctor catch any concerning changes early and adjust your dose before they become a problem. It's a routine and important part of staying safe on this medication.
How long does it take for WINREVAIR to start working?
Because of how long WINREVAIR stays in the body — its half-life is about 24 days — it takes around 15 weeks of regular dosing to build up to stable levels in your system. That means it may take a few months before you notice the full benefit. In clinical trials, patients showed meaningful improvements in exercise capacity and heart strain markers over the course of the study. Be patient with the process, keep your appointments, and let your doctor know how you're feeling along the way.
Is Sotatercept-Csrk available over the counter?
Sotatercept-Csrk is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Sotatercept-Csrk first available?
Sotatercept-Csrk has been available in the United States since at least 2024, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Sotatercept-Csrk?
Sotatercept-Csrk is supplied by 4 manufacturers listed in the FDA NDC Directory, including Merck Sharp & Dohme LLC, Patheon Italia S.p.A., AbbVie Inc..

💬 Answers drafted from Sotatercept-Csrk’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Sotatercept-Csrk comes

Sotatercept-Csrk is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Injection

By injection
How this form is used
What it may be used for
  • WINREVAIR injection is used to treat adults with pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity, improve WHO functional class, and reduce the risk of hospitalization, lung transplantation, or death related to PAH
Important instructions
  • WINREVAIR is given as a subcutaneous (under the skin) injection once every three weeks
  • WINREVAIR is started at a lower dose and increased to the target dose based on blood count monitoring and tolerability
  • WINREVAIR should not be administered if the patient is experiencing serious active bleeding
  • Hemoglobin and platelet counts must be checked before each of the first five doses of WINREVAIR, or longer if values are unstable, and periodically after that
Available strengths 2 strengths
2 FDA-listed product records

Oral solution

By mouth
Available strengths 2 strengths
2 FDA-listed product records

📊 Sotatercept-Csrk across the U.S. market

How Sotatercept-Csrk appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

2
Dose forms
4
Manufacturers
1
Brand names
24
FDA-listed product records
2024
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Kit (20) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Merck Sharp & Dohme LLC83%
Patheon Italia S.p.A.8%
AbbVie Inc.4%
SAMSUNG BIOLOGICS Co., Ltd.4%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Sotatercept-Csrk is used

A general measure of how commonly Sotatercept-Csrk is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Sotatercept-Csrk is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

10,198
Medicaid prescriptions filled (Q1–Q4 2025)
$184.4M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Sotatercept-Csrk prescribed? Of the 1,596 medications we measure, Sotatercept-Csrk ranks #931 by Medicaid prescriptions — more than 42% of them.

Where Sotatercept-Csrk ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Sotatercept-Csrk product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 45 mg injection is the most-dispensed Sotatercept-Csrk product — about 47% of these Medicaid prescriptions.

sotatercept-csrk 45 MG Injection Most dispensed

4,769 Medicaid prescriptions (Q1–Q4 2025) 47% of Sotatercept-Csrk prescriptions shown $70.2M gross reimbursement (before rebates) ≈ $14,727 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2678937

sotatercept-csrk 60 MG Injection

3,023 Medicaid prescriptions (Q1–Q4 2025) 30% of Sotatercept-Csrk prescriptions shown $44M gross reimbursement (before rebates) ≈ $14,562 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2678945

Other Sotatercept-Csrk products — combination packs and listings not yet matched to a specific clinical product (kept visible so every prescription is accounted for)

2,406 Medicaid prescriptions (Q1–Q4 2025) 24% of Sotatercept-Csrk prescriptions shown $70.2M gross reimbursement (before rebates) ≈ $29,165 per prescription (gross)

Summed across the 2 of 4 listed NDC products with Medicaid activity.

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Sotatercept-Csrk, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 4 of 8 listed Sotatercept-Csrk NDCs with Medicaid activity.

🔍 Compare Sotatercept-Csrk products

A representative set of FDA-listed product records for Sotatercept-Csrk — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Manufacturer / Labeler Category Details
💊Injection
45 mg/mL Patheon Italia S.p.A. DRUG FOR FURTHER PROCESSING View NDC →
60 mg/mL Patheon Italia S.p.A. DRUG FOR FURTHER PROCESSING View NDC →
💊Oral solution
1 g/g AbbVie Inc. BULK INGREDIENT View NDC →
1 kg/kg SAMSUNG BIOLOGICS Co., Ltd. BULK INGREDIENT View NDC →
💊Kits
Merck Sharp & Dohme LLC × 20 listings BLA View NDC →

Showing 24 of 24 products — FDA National Drug Code Directory. See every product, package size and price: browse all 24 Sotatercept-Csrk NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Sotatercept-Csrk RxCUI 2678930 1 dose form · 2 strengths
  1. Dose form (SCDF) Injection RxCUI 2678934 In current FDA listings
    Clinical drug / strength (SCD) csrk 45 MG RxCUI 2678937 csrk 60 MG RxCUI 2678945

Look up RxCUI 2678930 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Winrevair

🏭 Manufacturers & labelers

Merck Sharp & Dohme LLC 20 Patheon Italia S.p.A. 2 AbbVie Inc. 1 SAMSUNG BIOLOGICS Co., Ltd. 1

RxNorm drug class

Sotatercept-Csrk belongs to the Activin Signaling Inhibitor class.

Pharmacologic class Activin Signaling Inhibitor
Drug family (ATC) Antihypertensives for pulmonary arterial hypertension
How it works Activin Signaling Inhibitors

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Aug 12, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Sotatercept-Csrk.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Sotatercept-Csrk after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
1
NDC products indexed
24
Distinct labelers/manufacturers represented
4
Linked representative label
Merck Sharp & Dohme LLC
Linked label effective
Aug 12, 2026
Composite sections available
22
Linked SPL Set ID
21693ee2-cd23-4137-ac67-066bb3a4a9b7
Linked SPL Document ID
12e11c46-abc1-40b8-823e-0be043323f78
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Merck Sharp & Dohme LLC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.