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Letairis
Letairis, the brand name for ambrisentan, is a medication used to treat pulmonary arterial hypertension (PAH), a condition characterized by high blood pressure in the arteries of the lungs. By relaxing blood vessels in the lungs, Letairis helps improve blood flow and reduce the strain on the heart. It belongs to the class of drugs known as endothelin receptor antagonists (ERAs). Letairis helps improve exercise capacity and slow the progression of symptoms in patients with PAH.
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Frequently Asked Questions
How long does it take for Letairis to start working?
Letairis may take several weeks to show its full effect, although some patients may notice symptom improvement within a few weeks of starting treatment.
Can Letairis cure pulmonary arterial hypertension (PAH)?
No, Letairis does not cure PAH, but it helps manage symptoms and slow the progression of the disease, improving exercise capacity and quality of life.
What should I do if I miss a dose of Letairis?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and take the next dose at your regular time. Do not double the dose to make up for the missed one.
Can men take Letairis?
Yes, men can take Letairis for the treatment of PAH. However, women must follow the REMS program due to the pregnancy risks associated with the medication.
Is Letairis safe for long-term use?
Yes, Letairis is designed for long-term use in the management of PAH. However, regular monitoring of liver function and hemoglobin levels is important to ensure the safety of ongoing treatment.
Comprehensive Drug Guide
How Does Letairis Work?
Letairis works by blocking the effects of endothelin-1, a substance that causes blood vessels in the lungs to constrict and leads to increased blood pressure in pulmonary arteries. By inhibiting endothelin-1, Letairis helps relax the blood vessels, lowering blood pressure in the lungs and improving blood flow. This reduces the workload on the heart and helps alleviate symptoms such as shortness of breath and fatigue.
Common Dosages
- 5 mg oral tablets
- 10 mg oral tablets
The usual starting dose is 5 mg once daily, and the dose may be increased to 10 mg once daily, depending on the patient’s response and tolerability.
Typical Dosing
- For pulmonary arterial hypertension (PAH): The typical dose is 5 mg once daily, which may be increased to 10 mg once daily based on the patient's condition and tolerance.
Typical Dosing
FDA Approved Indications
- Treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise capacity and delay disease progression.
Who Shouldn't Take Letairis?
- Pregnancy: Letairis can cause fetal harm and is contraindicated in pregnant women.
- Severe liver impairment or elevated liver enzymes.
- Idiopathic pulmonary fibrosis (with or without secondary pulmonary hypertension).
Advice From The Pharmacist
- Take Letairis once daily, with or without food, at the same time each day for the best effect.
- Women who are taking Letairis must use effective contraception during treatment and for one month after discontinuing the drug, as it can cause severe birth defects.
- Letairis is available only through a special Risk Evaluation and Mitigation Strategy (REMS) program, requiring regular monitoring and pregnancy tests for female patients of childbearing potential.
- Monitor liver function regularly, as Letairis can affect liver enzymes. Report any symptoms of liver problems such as yellowing of the skin or eyes, dark urine, or severe fatigue.
- Do not stop taking Letairis suddenly without consulting your doctor, as it can worsen symptoms of pulmonary hypertension.
Side Effects of Letairis
Common Side Effects
- Peripheral edema (swelling in the legs or ankles)
- Nasal congestion
- Headache
- Flushing
- Palpitations
Uncommon/Severe Side Effects
- Liver toxicity (elevated liver enzymes)
- Anemia (low red blood cell count)
- Serious birth defects if taken during pregnancy
Risks and Warnings of Letairis
- Pregnancy Risk: Letairis is highly teratogenic (causes birth defects) and is contraindicated during pregnancy. Women must have a negative pregnancy test before starting treatment and use effective contraception during treatment and for one month after stopping the drug.
- Liver Function Monitoring: Letairis may cause liver damage. Regular blood tests are needed to monitor liver enzymes, and treatment should be discontinued if there are significant increases in liver enzymes.
- Anemia: Letairis can cause decreases in hemoglobin and red blood cell count. Patients should have regular blood tests to monitor for anemia.
Interactions with Letairis
Common Drug Interactions
- Rifampin: This drug may reduce the effectiveness of Letairis by increasing its metabolism.
- Cyclosporine: May increase blood levels of Letairis, so dose adjustments may be required.
- Hormonal contraceptives: While hormonal contraceptives are effective in preventing pregnancy, Letairis can interact with these, and additional non-hormonal contraception should be used.
Alternatives to Letairis
- Bosentan (Tracleer): Another endothelin receptor antagonist used to treat PAH.
- Macitentan (Opsumit): A newer endothelin receptor antagonist that is also used to treat PAH.
- Sildenafil (Revatio): A phosphodiesterase-5 (PDE5) inhibitor used for PAH to improve exercise ability.
- Tadalafil (Adcirca): Another PDE5 inhibitor used to manage PAH.
