Uptravi vs. Letairis for Pulmonary Hypertension: Important Differences and Potential Risks.

Key takeaways

Uptravi (selexipag) and Letairis (ambrisentan) are both medications used to treat pulmonary arterial hypertension (PAH), but they work in different ways. Uptravi is a prostacyclin agonist that helps relax blood vessels in the lungs, making it easier for your heart to pump blood. It is taken twice a day, either as an oral tablet or as an intravenous injection. On the other hand, Letairis is an endothelin receptor antagonist that blocks a protein called endothelin to relax blood vessels. It is taken once a day and is available as a lower-cost generic. One major difference is that Letairis can cause severe harm to unborn babies, so it is only available through a special REMS program for people who can get pregnant. Uptravi does not have this restriction. Additionally, Uptravi can cause side effects like headache and diarrhea, while Letairis commonly causes swelling in the arms or legs.

Uptravi

(selexipag)

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Ambrisentan

(Letairis)

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Summary for Uptravi

Prescription only

Uptravi (selexipag) is a prostacyclin agonist that's used in adults to treat pulmonary arterial hypertension (PAH), which is high blood pressure in the lungs. This medication can help prevent PAH from getting worse and lower the risk for hospitalization. Uptravi (selexipag) is a tablet that's taken by mouth twice per day. It's also available as an intravenous (IV) injection for people who can't take the medication by mouth. The most common side effects include headache, diarrhea, and nausea.

Indications for Uptravi

Pulmonary arterial hypertension or PAH (high blood pressure in the blood vessels in your lungs)

Pros and Cons for Uptravi

Pros

Can help prevent PAH from getting worse and lower the risk for hospitalizations
Tablets available in many different strengths
Available as an injection for people who temporarily can't take the medication by mouth

Cons

Can have a lot of side effects
Dose needs to be raised slowly
Not known if it's safe to take while pregnant or breastfeeding

Common Side Effects for Uptravi

Headache (65%)
Diarrhea (42%)
Nausea (33%)
Jaw pain (26%)
Vomiting (18%)
Pain in arms or legs (17%)
Muscle pain (16%)
Flushing (12%)

Warnings for Uptravi

Excess fluid in lungs

Summary for Letairis

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 Letairis

Pulmonary arterial hypertension (PAH)

Pros and Cons for Letairis

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