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Selective Endothelin-A Receptor Antagonist — Pulmonary Arterial Hypertension

Ambrisentan

Brand names: Volibris

Ambrisentan is an oral endothelin receptor antagonist used in the treatment of pulmonary arterial hypertension to improve exercise capacity and delay clinical worsening.

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 selectively antagonises the endothelin type A receptor, blocking endothelin-1-mediated vasoconstriction and vascular smooth muscle proliferation in the pulmonary circulation.

Prescribing in practice

  • It is contraindicated in pregnancy because of teratogenicity, so effective contraception and a pregnancy prevention approach are required in women of childbearing potential.
  • Avoid in idiopathic pulmonary fibrosis, including when associated with pulmonary hypertension.
  • Peripheral oedema and fluid retention are common and may require assessment for heart failure.

Monitoring

Monitor liver function and haemoglobin during treatment, and confirm a negative pregnancy test before starting in women of childbearing potential.

Counselling the patient

  • Do not become pregnant while taking this medicine and use reliable contraception.
  • Report swelling of the legs, breathlessness or signs of anaemia such as unusual tiredness.
  • Attend all blood test and monitoring appointments.

Evidence & guidelines

Pivotal randomised trials (ARIES programme) demonstrated improved exercise capacity and delayed clinical worsening in pulmonary arterial hypertension.

Reference: AMBITION Trial 2015; ARIES-1/2 Trials; NICE TA459; ESC/ERS PAH Guidelines 2022; 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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