Ambrisentan Accord: Uses, Dosage & Side Effects
A selective endothelin receptor antagonist (ERA) for the treatment of pulmonary arterial hypertension (PAH) in adults, adolescents, and children from 8 years of age
Ambrisentan Accord contains the active substance ambrisentan, a selective endothelin type A (ETA) receptor antagonist used to treat pulmonary arterial hypertension (PAH). PAH is a serious condition where the blood pressure in the arteries between the heart and lungs is dangerously elevated, forcing the heart to work harder and causing symptoms such as breathlessness, fatigue, and dizziness. Ambrisentan works by blocking the effect of endothelin-1, a powerful vasoconstrictor, thereby widening the pulmonary arteries and reducing the strain on the heart. It is approved for adults, adolescents, and children aged 8 years and older. This medication requires a prescription and must be initiated by a specialist experienced in treating PAH. Ambrisentan Accord is a generic version available from Accord Healthcare, with the same active ingredient found in other brands such as Ambrisentan Sandoz, Ambrisentan Bluefish, and Ambrisentan Viatris.
Quick Facts: Ambrisentan Accord
Key Takeaways
- Ambrisentan Accord is a selective endothelin type A receptor antagonist that reduces pulmonary vascular resistance, improving exercise capacity and symptoms in patients with pulmonary arterial hypertension (PAH).
- It is taken as a once-daily oral tablet (5 mg or 10 mg) and is approved for adults, adolescents, and children aged 8 years and older, with dosing adjusted by body weight in pediatric patients.
- Ambrisentan must not be used during pregnancy as it may cause serious birth defects; reliable contraception is mandatory for women of childbearing potential throughout treatment.
- Regular blood tests are required to monitor for anemia and liver function; the most common side effects include fluid retention (edema), headache, nasal congestion, and anemia.
- The AMBITION trial demonstrated that initial combination therapy with ambrisentan plus tadalafil significantly reduces the risk of clinical failure events compared with monotherapy in treatment-naive PAH patients.
What Is Ambrisentan Accord and What Is It Used For?
Ambrisentan Accord contains the active substance ambrisentan, which belongs to a class of medications known as endothelin receptor antagonists (ERAs). These medications target the endothelin system, a key pathway involved in the regulation of blood vessel tone and remodeling. Endothelin-1 (ET-1) is the most potent naturally occurring vasoconstrictor in the human body. It is produced primarily by vascular endothelial cells and exerts its effects through two receptor subtypes: the endothelin type A (ETA) receptor, found predominantly on vascular smooth muscle cells, and the endothelin type B (ETB) receptor, found on both endothelial and smooth muscle cells.
In patients with pulmonary arterial hypertension, circulating levels of endothelin-1 are significantly elevated, sometimes several-fold above normal. This excess ET-1 drives sustained vasoconstriction, promotes proliferation of smooth muscle cells in the walls of pulmonary arteries, and contributes to the progressive vascular remodeling that is the hallmark of PAH. Over time, these changes cause the pulmonary arteries to narrow and stiffen, increasing pulmonary vascular resistance and forcing the right ventricle of the heart to pump against an ever-increasing afterload. Without treatment, the right ventricle eventually fails, leading to severe disability and premature death.
Ambrisentan is a selective ETA receptor antagonist. Unlike dual ERAs such as bosentan or macitentan, which block both ETA and ETB receptors, ambrisentan preferentially targets the ETA subtype. The rationale for selectivity is based on the different roles of the two receptors: ETA receptors on smooth muscle cells mediate vasoconstriction and cell proliferation, whereas ETB receptors on endothelial cells promote the release of vasodilators such as nitric oxide and prostacyclin, and also play a role in ET-1 clearance. By selectively blocking ETA while leaving ETB function relatively intact, ambrisentan aims to maximize vasodilation while preserving endogenous vasodilatory and clearance mechanisms.
Ambrisentan Accord is used for the treatment of pulmonary arterial hypertension (PAH) classified as WHO Functional Class II and III, to improve exercise capacity and reduce the rate of clinical worsening. It is approved for use in adults, adolescents, and children from 8 years of age. PAH is a rare but serious condition with an estimated prevalence of 15 to 50 cases per million adults, and it predominantly affects women of childbearing age (the female-to-male ratio is approximately 3:1 to 4:1). PAH can occur as an idiopathic condition, can be heritable, or can be associated with connective tissue diseases (particularly systemic sclerosis), congenital heart disease, HIV infection, portal hypertension, or drug and toxin exposure.
Clinical trials have demonstrated that ambrisentan improves functional capacity as measured by the 6-minute walk distance (6MWD) test, delays time to clinical worsening, and improves WHO functional class in patients with PAH. The pivotal ARIES-1 and ARIES-2 trials were randomized, double-blind, placebo-controlled studies that showed statistically significant improvements in 6MWD at 12 weeks in patients receiving ambrisentan compared with placebo. Furthermore, the landmark AMBITION trial (2015) demonstrated that initial combination therapy with ambrisentan plus the PDE5 inhibitor tadalafil significantly reduced the risk of clinical failure events (a composite of death, hospitalization for worsening PAH, disease progression, and unsatisfactory long-term clinical response) by 50% compared with either drug alone, establishing combination therapy as a new standard of care for treatment-naive PAH patients.
Current ESC/ERS guidelines (2022) recommend initial combination therapy with an ERA (such as ambrisentan) and a PDE5 inhibitor (such as tadalafil or sildenafil) for most newly diagnosed PAH patients at intermediate or high risk. Ambrisentan can also be used alongside prostacyclin pathway agents (such as iloprost or epoprostenol) in patients requiring escalation of therapy. Your specialist will determine the most appropriate treatment regimen based on your individual risk assessment.
What Should You Know Before Taking Ambrisentan Accord?
Contraindications
There are several important situations in which Ambrisentan Accord must not be used. Understanding these contraindications is essential for safe treatment. Do not take this medication if any of the following apply to you:
- Allergy to ambrisentan or soy: Ambrisentan Accord contains soy-derived lecithin as an excipient. If you are allergic to ambrisentan, soy, or any other ingredient in this medicine, you must not take it. Allergic reactions can range from mild skin rashes to severe anaphylaxis.
- Pregnancy or planned pregnancy: Ambrisentan has been shown to be teratogenic (causing birth defects) in animal studies. It is absolutely contraindicated in women who are pregnant, planning to become pregnant, or who could become pregnant and are not using reliable contraception.
- Breastfeeding: It is not known whether ambrisentan passes into breast milk. Because of the potential for serious adverse effects in the nursing infant, breastfeeding must be discontinued during treatment.
- Severe liver disease: Patients with significant hepatic impairment should not take ambrisentan, as the drug is metabolized by the liver and impaired clearance could lead to dangerously elevated drug levels.
- Idiopathic pulmonary fibrosis (IPF): Ambrisentan must not be used in patients with pulmonary fibrosis of unknown cause (idiopathic pulmonary fibrosis), with or without secondary pulmonary hypertension. Clinical studies have shown that ambrisentan does not benefit and may worsen outcomes in this patient population.
Ambrisentan can cause serious harm to an unborn baby. Women of childbearing potential must have a negative pregnancy test before starting treatment and use reliable contraception throughout therapy. Pregnancy tests should be repeated monthly during treatment. If you become pregnant or suspect pregnancy while taking Ambrisentan Accord, stop the medication and contact your doctor immediately.
Warnings and Precautions
Before starting Ambrisentan Accord, inform your doctor about all your medical conditions. Special caution is needed in the following situations:
- Liver problems: Your doctor will perform liver function tests before starting treatment and periodically during therapy. Signs that your liver may not be functioning properly include loss of appetite, nausea, vomiting, fever, stomach pain, yellowing of the skin or whites of the eyes (jaundice), dark-colored urine, and itching. Report any of these symptoms to your doctor immediately.
- Anemia: Ambrisentan can decrease hemoglobin levels and red blood cell counts. Your doctor will check your blood counts before starting treatment and regularly during therapy. Symptoms of anemia include fatigue, weakness, shortness of breath, and a general feeling of being unwell. In some cases, blood transfusions may be necessary.
- Fluid retention (edema): Swelling of the hands, ankles, or feet caused by fluid accumulation is common with ambrisentan. If you already have peripheral edema, your doctor will monitor you closely and may need to adjust your treatment.
- Pulmonary veno-occlusive disease (PVOD): If you have a lung condition where the veins in the lungs are blocked, ambrisentan may not be appropriate for you, as pulmonary vasodilators can worsen oxygenation in PVOD.
Pregnancy and Breastfeeding
The safety of ambrisentan during pregnancy has not been established in humans, but animal reproductive studies have demonstrated clear evidence of harm to the developing fetus, including cardiovascular and skeletal abnormalities. Endothelin receptor antagonists as a class are considered teratogenic, and the risk to a human fetus is considered to be substantial.
If you are a woman of childbearing potential, your doctor will require a pregnancy test before initiating treatment. You must use a reliable method of contraception throughout the duration of therapy and for at least one month after discontinuation. Monthly pregnancy testing during treatment is recommended. If you become pregnant while taking Ambrisentan Accord, discontinue the medication immediately and contact your doctor, as urgent medical assessment is needed.
It is not known whether ambrisentan or its metabolites are excreted in human breast milk. Given the serious potential for adverse effects on the nursing infant, breastfeeding is contraindicated during treatment with Ambrisentan Accord. Discuss alternative feeding options with your healthcare provider.
Male patients should be aware that ambrisentan may reduce sperm count. If you are a man taking Ambrisentan Accord and have concerns about fertility, discuss this with your doctor. Sperm banking prior to treatment initiation may be considered in selected cases.
Driving and Operating Machinery
Ambrisentan Accord can cause side effects such as low blood pressure, dizziness, and fatigue, which may impair your ability to drive or operate machinery safely. The symptoms of PAH itself, including breathlessness and fatigue, can also affect your alertness and reaction times. Do not drive or operate machinery if you feel unwell, dizzy, or excessively tired. You are responsible for assessing whether you are fit to perform activities that require alertness.
Important Information About Ingredients
Ambrisentan Accord tablets contain several excipients that some patients need to be aware of:
- Lactose: The tablets contain small amounts of lactose monohydrate. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
- Soy lecithin (E322): The film coating contains lecithin derived from soy. If you are allergic to soy, do not take this medicine.
- Allura Red AC aluminum lake (E129): The 5 mg tablets contain this coloring agent, which may cause allergic reactions in susceptible individuals.
- Sodium: This medicine contains less than 1 mmol sodium (23 mg) per tablet, meaning it is essentially sodium-free.
How Does Ambrisentan Accord Interact with Other Drugs?
Drug interactions can alter the effectiveness and safety of medications. Ambrisentan is metabolized primarily through glucuronidation (via UGT enzymes) and oxidation (via CYP3A4 and CYP2C19). It is also a substrate of organic anion transporting polypeptides (OATP1B1 and OATP1B3) and P-glycoprotein. Medications that inhibit or induce these pathways may change the blood levels of ambrisentan, potentially affecting its efficacy or increasing the risk of side effects.
Unlike the dual ERA bosentan, ambrisentan does not induce CYP enzymes and does not typically cause clinically significant reductions in the effectiveness of hormonal contraceptives. This is an important pharmacological advantage, as it allows women of childbearing potential to use hormonal contraception reliably while on treatment. Nevertheless, the use of two methods of contraception is still recommended as a precaution.
Major Interactions
| Drug | Effect | Clinical Action |
|---|---|---|
| Cyclosporine A | Significantly increases ambrisentan plasma levels (approximately 2-fold increase in AUC) via OATP and P-gp inhibition | Limit ambrisentan dose to 5 mg once daily; close monitoring required |
| Rifampicin | May transiently increase ambrisentan levels upon initiation (OATP inhibition), though steady-state effects are modest | Close monitoring when initiating rifampicin; dose adjustment may not be needed at steady state |
Combination PAH Therapies
Ambrisentan is frequently used in combination with other medications for PAH. These combinations are well-established in clinical practice and supported by guideline recommendations. However, combination therapy should always be managed by a specialist experienced in PAH treatment.
| Drug | Class | Notes |
|---|---|---|
| Tadalafil | PDE5 inhibitor | Recommended first-line combination per AMBITION trial; enhanced monitoring for side effects needed |
| Sildenafil | PDE5 inhibitor | Alternative PDE5 inhibitor combination; monitor for hypotension and headache |
| Iloprost | Prostacyclin analogue | May be added as escalation therapy; monitor blood pressure |
| Epoprostenol | Prostacyclin | Intravenous prostacyclin for severe PAH; specialist management required |
Always inform your doctor, pharmacist, or healthcare professional about any medications you are currently taking, have recently taken, or might take, including over-the-counter medicines, herbal supplements, and vitamins. Even seemingly unrelated medications could interact with ambrisentan.
What Is the Correct Dosage of Ambrisentan Accord?
Always take Ambrisentan Accord exactly as your doctor or pharmacist has told you. Do not change your dose without medical advice. The dosage depends on your age, weight, kidney and liver function, and whether you are taking certain other medications. Your specialist will determine the most appropriate dose for you.
Adults
Standard Adult Dosage
The recommended starting dose is 5 mg once daily. Your doctor may increase this to 10 mg once daily based on your clinical response and tolerability. If you are also taking cyclosporine A, the maximum dose is limited to 5 mg once daily.
Ambrisentan should be taken at approximately the same time each day. Swallow the tablet whole with a glass of water. Do not split, crush, or chew the tablet, as this could affect the controlled release of the medication. The tablet may be taken with or without food. If you miss a dose, take it as soon as you remember, then continue with your normal dosing schedule. Do not take a double dose to make up for a forgotten one.
Children and Adolescents (8 to under 18 years)
Ambrisentan is approved for use in children and adolescents aged 8 years and older. Dosing in pediatric patients is based on body weight. It is important that children attend their regular medical appointments, as the dose may need to be adjusted as they grow and gain weight.
| Body Weight | Starting Dose | Notes |
|---|---|---|
| 35 kg or more | 5 mg once daily | May be increased by the doctor based on response |
| 20 kg to less than 35 kg | 2.5 mg once daily | A 2.5 mg tablet formulation may be required |
If a child is also taking cyclosporine A, the ambrisentan dose is limited: for children weighing less than 50 kg, the maximum dose is 2.5 mg once daily; for those weighing 50 kg or more, the maximum is 5 mg once daily. Children under 8 years of age should not take this medication, as its safety and effectiveness have not been established in this age group.
Elderly Patients
No specific dose adjustment is recommended for elderly patients. However, since older adults are more likely to have reduced kidney or liver function and to be taking other medications, treatment should be initiated and monitored carefully. Your doctor will assess your overall health and adjust therapy as needed.
Missed Dose
If you forget to take a dose of Ambrisentan Accord, take it as soon as you remember on the same day. Then take your next dose at the usual time. Do not take two tablets at the same time or a double dose to compensate for a missed dose. If you are unsure, contact your pharmacist or doctor for guidance.
Overdose
If you take more Ambrisentan Accord than prescribed, the risk of side effects increases. Symptoms of overdose may include severe headache, flushing, dizziness, nausea, and low blood pressure (hypotension), which can cause lightheadedness or fainting. If you suspect an overdose, seek medical attention immediately by contacting your doctor, visiting the nearest emergency department, or calling your local poison control center.
Ambrisentan Accord is a long-term treatment for controlling PAH. Do not stop taking it without your doctor’s agreement, even if you feel better. Abrupt discontinuation can lead to a rebound worsening of pulmonary hypertension symptoms. Your doctor will guide you if treatment needs to be stopped.
What Are the Side Effects of Ambrisentan Accord?
Like all medicines, Ambrisentan Accord can cause side effects, although not everybody gets them. Some side effects are serious and require immediate medical attention, while others are milder and may improve as your body adjusts to the medication. Below is a comprehensive overview of known side effects, organized by frequency to help you understand how likely they are to occur.
Serious Side Effects
Contact your doctor immediately if you experience any of the following serious side effects:
- Allergic reactions (common): Skin rash, itching, swelling (usually of the face, lips, tongue, or throat) which may cause difficulty breathing or swallowing.
- Peripheral edema (very common): Swelling of the ankles, feet, legs, or hands caused by fluid retention. While often mild, significant edema may indicate fluid overload requiring treatment adjustment.
- Heart failure (common): If your heart is not pumping enough blood, you may experience increasing breathlessness, extreme tiredness, or worsening swelling of the ankles and legs.
- Anemia (very common): A decrease in red blood cells that sometimes requires blood transfusion. Symptoms include fatigue, weakness, breathlessness, and a general feeling of being unwell.
- Low blood pressure (common): Dizziness, lightheadedness, or fainting, particularly when standing up.
Side Effect Frequency Grid
Very Common
May affect more than 1 in 10 people
- Headache
- Dizziness
- Palpitations (fast or irregular heartbeat)
- Worsening breathlessness shortly after starting treatment
- Nasal congestion or runny nose, sinus pain
- Nausea
- Diarrhea
- Fatigue
- Peripheral edema (swelling of ankles/feet)
- Anemia (reduced red blood cells)
Common
May affect up to 1 in 10 people
- Blurred vision or other visual changes
- Fainting (syncope)
- Abnormal liver function blood tests
- Runny nose (rhinorrhea)
- Constipation
- Stomach pain
- Chest pain or discomfort
- Flushing (skin redness)
- Vomiting
- Feeling of weakness
- Nosebleeds (epistaxis)
- Skin rash
- Allergic reactions
- Heart failure
- Low blood pressure (hypotension)
Uncommon
May affect up to 1 in 100 people
- Liver damage (hepatotoxicity)
- Autoimmune hepatitis (liver inflammation caused by the immune system)
Side Effects When Combined with Tadalafil
When Ambrisentan Accord is taken in combination with tadalafil (another PAH medication), the following additional side effects have been reported:
- Very common: Flushing (skin redness), vomiting, chest pain or discomfort (in addition to the above very common effects).
- Common: Tinnitus (ringing in the ears).
- Uncommon: Sudden hearing loss.
The side effects observed in children and adolescents are expected to be similar to those seen in adults. If you notice any side effects not listed here, or if any side effect becomes severe, contact your doctor or pharmacist. Reporting of suspected adverse reactions is important for ongoing safety monitoring of medicines.
Regular blood tests are essential during treatment with Ambrisentan Accord. Your doctor will monitor your hemoglobin levels (to check for anemia) and liver function. Attend all scheduled blood test appointments to ensure your safety throughout treatment.
How Should You Store Ambrisentan Accord?
Proper storage of medications is important to ensure they remain effective and safe to use. Keep Ambrisentan Accord out of the sight and reach of children at all times. The tablets are supplied in special child-resistant blister packaging to help prevent accidental ingestion by children, but additional precautions should always be taken.
There are no special storage requirements for Ambrisentan Accord tablets. Store them at room temperature, away from excessive heat, moisture, and direct sunlight. Do not use this medicine after the expiry date stated on the carton and blister after "EXP." The expiry date refers to the last day of the indicated month.
Do not dispose of medications by flushing them down the toilet or throwing them in household waste, as this may contaminate the environment. Return any unused or expired tablets to your local pharmacy for safe disposal. Ask your pharmacist about medication take-back programs available in your area.
What Does Ambrisentan Accord Contain?
Active Ingredient
The active substance in Ambrisentan Accord is ambrisentan. Each 5 mg film-coated tablet contains 5 mg of ambrisentan, and each 10 mg film-coated tablet contains 10 mg of ambrisentan. Ambrisentan is a propanoic acid derivative that selectively antagonizes the endothelin type A receptor.
Inactive Ingredients (Excipients)
The other ingredients in Ambrisentan Accord are:
- Tablet core: Microcrystalline cellulose, croscarmellose sodium, lactose monohydrate, magnesium stearate.
- Film coating: Polyvinyl alcohol (partially hydrolyzed), titanium dioxide (E171), talc, macrogol (polyethylene glycol), lecithin (soy) (E322), and Allura Red AC aluminum lake (E129).
Tablet Appearance and Pack Sizes
The 5 mg tablet is a light pink, round, biconvex film-coated tablet debossed with "5" on one side, approximately 7.0 mm in diameter. The 10 mg tablet is a dark pink, oval, biconvex film-coated tablet debossed with "10" on one side, approximately 9.9 mm × 5.0 mm.
Ambrisentan Accord is available in unit-dose blister packs (aluminum/aluminum foil or PVC/PVDC/aluminum foil) containing 10 × 1 or 30 × 1 tablets. Not all pack sizes may be marketed in every country.
Marketing Authorization Holder
Accord Healthcare B.V., Winthontlaan 200, 3526 KV Utrecht, The Netherlands.
Frequently Asked Questions About Ambrisentan Accord
Pulmonary arterial hypertension (PAH) is a rare, progressive disease in which the blood pressure in the arteries connecting the heart to the lungs is abnormally elevated. This high pressure is caused by narrowing and stiffening of the pulmonary arteries, which forces the right side of the heart to work much harder than normal. Over time, this extra workload can weaken the heart, leading to right heart failure. Symptoms include breathlessness during activity, fatigue, dizziness, and swelling of the ankles. Ambrisentan helps by blocking the endothelin type A receptor, which reduces the constriction of pulmonary arteries, lowers the pressure in these vessels, and makes it easier for the heart to pump blood through the lungs. Clinical trials have shown that ambrisentan improves exercise capacity and delays disease progression.
Ambrisentan reaches peak blood levels approximately 2 hours after taking a dose, and its pharmacological effects begin shortly thereafter. However, the clinical benefits of treatment—such as improved exercise capacity and reduced symptoms—develop gradually over weeks. In clinical trials, statistically significant improvements in 6-minute walk distance were observed at 12 weeks. Some patients may notice symptom improvement earlier, while others may take longer. It is important to continue taking the medication as prescribed even if you do not notice immediate changes, as the full therapeutic benefit takes time to develop.
Yes, Ambrisentan Accord can be taken with or without food. Food does not significantly affect the absorption or efficacy of the medication. However, it is recommended to take the tablet at the same time each day to maintain consistent blood levels. Swallow the tablet whole with a glass of water. Do not split, crush, or chew the tablet.
Ambrisentan is a selective endothelin type A (ETA) receptor antagonist, meaning it primarily blocks only the ETA receptor subtype. Other ERAs like bosentan and macitentan are dual receptor antagonists that block both ETA and ETB receptors. The clinical significance of selectivity is debated, but one practical advantage of ambrisentan is that it does not induce liver enzymes (CYP450), so it has fewer drug interactions and does not reduce the effectiveness of hormonal contraceptives. All three ERAs have demonstrated efficacy in PAH clinical trials, and the choice between them depends on individual patient factors, tolerability, and co-medications.
Yes, Ambrisentan Accord is a generic formulation that contains the same active ingredient (ambrisentan) in the same strengths as other approved ambrisentan products, including Ambrisentan Sandoz, Ambrisentan Bluefish, and Ambrisentan Viatris. Generic medications must meet rigorous regulatory standards for bioequivalence, meaning they deliver the same amount of active drug to the bloodstream at the same rate as the reference product. The European Medicines Agency (EMA) has approved Ambrisentan Accord as therapeutically equivalent to the originator product.
Peripheral edema (swelling of the ankles, feet, or legs) is one of the most common side effects of ambrisentan, occurring in more than 1 in 10 patients. Mild swelling can often be managed with compression stockings, leg elevation, and dietary salt reduction. However, if the swelling is sudden, severe, or progressive, or if it is accompanied by significant weight gain, increasing breathlessness, or chest pain, contact your doctor promptly. These symptoms could indicate heart failure or fluid overload requiring medical assessment and possible treatment adjustment.
References
- European Medicines Agency (EMA). Ambrisentan – Summary of Product Characteristics. Last updated 2024. Available at: www.ema.europa.eu
- Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. European Heart Journal. 2022;43(38):3618–3731. doi:10.1093/eurheartj/ehac237
- Galiè N, Olschewski H, Oudiz RJ, et al. Ambrisentan for the treatment of pulmonary arterial hypertension: results of the ambrisentan in pulmonary arterial hypertension, randomized, double-blind, placebo-controlled, multicenter, efficacy (ARIES) study 1 and 2. Circulation. 2008;117(23):3010–3019. doi:10.1161/CIRCULATIONAHA.107.742510
- Galiè N, Barberà JA, Frost AE, et al. Initial use of ambrisentan plus tadalafil in pulmonary arterial hypertension (AMBITION). New England Journal of Medicine. 2015;373(9):834–844. doi:10.1056/NEJMoa1413687
- U.S. Food and Drug Administration (FDA). Letairis (ambrisentan) – Prescribing Information. Available at: www.accessdata.fda.gov
- World Health Organization (WHO). Model List of Essential Medicines – 23rd List, 2023. Available at: www.who.int
- Klinger JR, Elliott CG, Galiè N, et al. An updated review of the role of endothelin receptor antagonists in the treatment of pulmonary arterial hypertension. Pulmonary Circulation. 2021;11(2). doi:10.1177/20458940211015356
- British National Formulary (BNF). Ambrisentan – Drug Monograph. Available at: bnf.nice.org.uk
Editorial Team
This article was prepared and reviewed by the iMedic Medical Editorial Team, comprising licensed specialists in pulmonology, cardiology, and clinical pharmacology.
Medical Content
iMedic Medical Writers – Licensed physicians with expertise in pulmonary vascular medicine and pharmacotherapy
Medical Review
iMedic Medical Review Board – Independent panel following ESC/ERS, EMA, and WHO guidelines
Pharmacological Review
Clinical Pharmacology Specialists – Drug interaction and dosing verification
Editorial Standards
Evidence Level 1A – Based on systematic reviews and randomized controlled trials
Last medical review: . Next scheduled review: June 2026. All content follows the iMedic Editorial Standards and GRADE evidence framework.