Ambrisentan vs. Bosentan for Pulmonary Hypertension: Important Differences and Potential Risks.

Ambrisentan

(Letairis)

Bosentan

(Tracleer)

Summary for Ambrisentan

Prescription only

Ambrisentan, also known by its brand name Letairis, is a medication used for pulmonary arterial hypertension (PAH), or high blood pressure in the blood vessels of the lungs. This medication is available as a lower-cost generic. The usual dose is one tablet daily. Ambrisentan (Letairis) is generally well-tolerated, though the most common side effect is swelling in the arms or legs. It also has a risk of causing severe and life-threatening harm to unborn babies, so the medication is only available through the Ambrisentan REMS program for people who can get pregnant.

Indications for Ambrisentan

Pulmonary arterial hypertension (PAH)

Pros and Cons for Ambrisentan

Pros

Works well to slow the worsening of PAH and improve ability to breathe and exercise
Taken once a day with or without food
Generally mild or moderate side effects
Only available through a REMS program so that it's safe for people who can become pregnant

Cons

Not a cure for PAH
Might affect sperm count and ability to have children in males
Females who can have children must use birth control and take a pregnancy test every month
Not for people with a lung problem called idiopathic pulmonary fibrosis (IPF) because of risk of harm

Common Side Effects for Ambrisentan

Swelling in the arms or legs (17%)
Stuffy nose (6%)
Flushing (4%)
Sinus infection or inflammation (3%)

Warnings for Ambrisentan

Not safe to use during pregnancy
Fluid buildup in the body
Anemia (low red blood cell count)

Summary for Bosentan

Prescription only

Bosentan (Tracleer) improves your ability to exercise and slows worsening of pulmonary arterial hypertension (PAH), but it has several drug interactions and can cause liver damage.

Indications for Bosentan

Pulmonary arterial hypertension (PAH)

Pros and Cons for Bosentan

Pros

Helps slow down the worsening of PAH, so you are able to live longer with the condition
Can make it easier to breathe, exercise, and walk longer distances
Can be used in children as young as 3 years old
Also available as a dissolvable tablet
Safe to use if you have kidney problems

Cons

If you are female, you will need to use birth control and take pregnancy tests every month.
Not all pharmacies can fill bosentan (Tracleer) prescriptions.
Can affect male sperm count and ability to have children
Can cause serious liver damage
Cannot be taken with cyclosporine A or glyburide