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Dual Endothelin/Angiotensin Receptor Antagonist (IgA Nephropathy)

Sparsentan

Brand names: Filspari

Sparsentan is an oral dual endothelin and angiotensin II receptor antagonist used to reduce proteinuria and slow progression in IgA nephropathy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It simultaneously blocks the endothelin type A receptor and the angiotensin II type 1 receptor, reducing glomerular pressure, proteinuria and renal injury.

Prescribing in practice

  • Sparsentan can cause hepatotoxicity and is teratogenic, so it is subject to a controlled-access programme with mandatory liver monitoring and pregnancy prevention.
  • Fluid retention and hypotension may occur, and renal function can decline initially, requiring monitoring after initiation and dose changes.
  • Avoid co-administration with other renin-angiotensin or endothelin receptor blockers, and review interacting drugs as set out in the SPC.

Monitoring

Monitor liver enzymes, blood pressure, renal function and fluid status, and confirm pregnancy status before and during treatment.

Counselling the patient

  • Effective contraception is essential; this medicine can seriously harm an unborn baby.
  • Attend all scheduled liver and kidney blood tests, and report swelling, dizziness or yellowing of the skin.

Evidence & guidelines

Sparsentan reduced proteinuria in IgA nephropathy in the randomised PROTECT trial, and is regulated under a risk-minimisation programme.

Reference: Heerspink et al. NEJM 2023 (PROTECT trial); KDIGO IgA Nephropathy Clinical Practice Guidelines 2021; MHRA SPC Filspari; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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