Which of the following medications would be most likely to interact with selexipag?

Selexipag is a selective prostacyclin receptor agonist primarily used in the treatment of pulmonary arterial hypertension. It can be subject to interactions with other medications that influence its metabolism or therapeutic efficacy. Clopidogrel, an antiplatelet agent, is particularly relevant in this context.

Clopidogrel is a prodrug that requires metabolic activation, primarily via the CYP2C19 enzyme. Since selexipag is metabolized by various CYP enzymes, including CYP2C8 and CYP3A4, there is a potential for interaction. Clopidogrel may alter the pharmacokinetics of selexipag, as it can affect the metabolism of drugs processed by the same enzyme systems. This interaction could lead to changes in selexipag's effectiveness and safety profile in patients using both medications.

The other options, while they may have their own unique interactions, are not as prominently associated with significant metabolic interactions with selexipag. Atorvastatin, for instance, is also metabolized by CYP enzymes but does not primarily affect selexipag's metabolism in a clinically significant manner. Glyburide, an oral hypoglycemic agent, and prazosin, an antihypertensive, have different