Ambrisentan interactions
Full monograph for AmbrisentanCheck it against another medicine
Medicines
303 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Cyclosporine (Oral) | Major | Excretion | Coadministration with cyclosporine may increase the plasma concentrations of ambrisentan. The mechanism is cyclosporine inhibition of P-glycoprotein efflux… | 14 sources — open the full entry |
| Leflunomide | Major | Synergy | The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity may… | 3 sources — open the full entry |
| Tizanidine Hydrochloride | Major | Synergy | Tizanidine may potentiate the hypotensive effect of some medications secondary to its alpha-2 adrenergic activity. Pharmacologic studies have found tizanidine… | 1 sources — open the full entry |
| Apalutamide | Moderate | Absorption · Metabolism | Coadministration with apalutamide may decrease the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 3A4, 2C9, 2C19, breast… | 5 sources — open the full entry |
| Asciminib | Moderate | Others | Coadministration with asciminib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. In vitro… | 1 sources — open the full entry |
| Avanafil | Moderate | Synergy | Phosphodiesterase-5 (PDE5) inhibitors may potentiate the blood pressure-lowering effect of antihypertensive medications. These agents inhibit PDE5-mediated… | 4 sources — open the full entry |
| Bempedoic acid | Moderate | Metabolism | Coadministration with bempedoic acid may increase the plasma concentrations and the risk of adverse effects of drugs that are substrates of the uptake… | 3 sources — open the full entry |
| Bempedoic acid + Ezetimibe | Moderate | Metabolism · Unknown | Coadministration with bempedoic acid may increase the plasma concentrations and the risk of adverse effects of drugs that are substrates of the uptake…2 documented mechanisms | 3 sources — open the full entry |
| Brigatinib | Moderate | Excretion | Coadministration with brigatinib may increase the plasma concentrations and risk of adverse effects of drugs that are substrates of P-glycoprotein (P-gp)… | 4 sources — open the full entry |
| Cabozantinib | Moderate | Others | Based on in vitro inhibition data, coadministration with cabozantinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein… | 2 sources — open the full entry |
| Canagliflozin Hemihydrate | Moderate | Synergy | Sodium-glucose co-transporter 2 (SGLT-2) inhibitors may potentiate the hypotensive effects of diuretics and other antihypertensive agents or vasodilators… | 15 sources — open the full entry |
| Capmatinib Hydrochloride | Moderate | Absorption | Coadministration with capmatinib may increase the plasma concentrations and risk of adverse effects of drugs that are substrates of P-glycoprotein (P-gp)… | 1 sources — open the full entry |
| Copper Peptide + Procapil + Niacinamide + Biotin + L-Arginine | Moderate | Synergy | Coadministration of L-arginine or L-citrulline may potentiate the hypotensive effects of nitrates and vasodilators. Both L-arginine and L-citrulline are amino… | 1 sources — open the full entry |
| Daclatasvir | Moderate | Excretion | Coadministration with daclatasvir may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Daclatasvir + Sofosbuvir | Moderate | Excretion | Coadministration with daclatasvir may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Dapagliflozin Propanediol | Moderate | Synergy | Sodium-glucose co-transporter 2 (SGLT-2) inhibitors may potentiate the hypotensive effects of diuretics and other antihypertensive agents or vasodilators… | 15 sources — open the full entry |
| Darolutamide | Moderate | Metabolism | Coadministration with darolutamide may increase the plasma concentrations of drugs that are substrates of the organic anion transporting polypeptides (OATP)… | 4 sources — open the full entry |
| Deferasirox | Moderate | Metabolism | Coadministration with deferasirox may decrease the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. The mechanism may involve… | 3 sources — open the full entry |
| Efavirenz | Moderate | Metabolism | Coadministration with efavirenz may decrease the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. The mechanism is accelerated… | 2 sources — open the full entry |
| Elacestrant | Moderate | Absorption | Coadministration with elacestrant may increase the plasma concentrations of drugs that are substrates of P-glycoprotein (P-gp) and/or breast cancer resistance… | 1 sources — open the full entry |
| Elagolix Sodium | Moderate | Others | Coadministration with elagolix may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Empagliflozin | Moderate | Synergy | Sodium-glucose co-transporter 2 (SGLT-2) inhibitors may potentiate the hypotensive effects of diuretics and other antihypertensive agents or vasodilators… | 15 sources — open the full entry |
| Empagliflozin + Linagliptin | Moderate | Synergy | Sodium-glucose co-transporter 2 (SGLT-2) inhibitors may potentiate the hypotensive effects of diuretics and other antihypertensive agents or vasodilators… | 15 sources — open the full entry |
| Empagliflozin + Metformin Hydrochloride | Moderate | Synergy · Unknown | Sodium-glucose co-transporter 2 (SGLT-2) inhibitors may potentiate the hypotensive effects of diuretics and other antihypertensive agents or vasodilators…2 documented mechanisms | 15 sources — open the full entry |
| Enasidenib | Moderate | Distribution | Based on in vitro data, coadministration with enasidenib may increase the plasma concentrations of drugs that are substrates of the transporters, organic anion… | 3 sources — open the full entry |
| Enzalutamide | Moderate | Metabolism | Coadministration with enzalutamide may decrease the plasma concentrations of drugs that are substrates of CYP450 3A4, 2C9, 2C19, and/or P-glycoprotein (P-gp)… | 4 sources — open the full entry |
| Epirubicin Hydrochloride | Moderate | Synergy | The concomitant or sequential use of epirubicin with agents known to induce hepatotoxicity may potentiate the risk of liver injury. Epirubicin undergoes… | 4 sources — open the full entry |
| Erdafitinib | Moderate | Distribution | Coadministration with erdafitinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) efflux transporter… | 1 sources — open the full entry |
| Ertugliflozin | Moderate | Synergy | Sodium-glucose co-transporter 2 (SGLT-2) inhibitors may potentiate the hypotensive effects of diuretics and other antihypertensive agents or vasodilators… | 15 sources — open the full entry |
| Finerenone | Moderate | Synergy | Concomitant use of multiple other antihypertensive agents or drugs with hypotensive properties may potentiate the risk of hypotension during treatment with… | 1 sources — open the full entry |
| Gemfibrozil | Moderate | Excretion | Coadministration with gemfibrozil may increase the plasma concentrations of drugs that are substrates of the organic anion transporting polypeptide (OATP) 1B1… | 2 sources — open the full entry |
| Gilteritinib Fumarate | Moderate | Absorption | Coadministration with gilteritinib may increase the plasma concentrations and the risk of adverse effects of orally administered drugs that are substrates of… | 3 sources — open the full entry |
| Ibrutinib | Moderate | Absorption | Coadministration with ibrutinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) efflux transporter. In vitro… | 21 sources — open the full entry |
| Isosorbide Dinitrate + Hydralazine Hydrochloride | Moderate | Synergy | Concomitant treatment with other antihypertensive agents or vasodilators, including alpha-adrenoreceptor antagonists, angiotensin converting enzyme (ACE)… | 2 sources — open the full entry |
| Istradefylline | Moderate | Others | Coadministration with istradefylline may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| L-arginie + Proanthocyanidin + Folic Acid + Zinc | Moderate | Synergy · Unknown | Coadministration of L-arginine or L-citrulline may potentiate the hypotensive effects of nitrates and vasodilators. Both L-arginine and L-citrulline are amino…2 documented mechanisms | 1 sources — open the full entry |
| L-Asparginase | Moderate | Synergy | Concomitant use of asparaginase with other hepatotoxic agents may potentiate the risk of liver injury. Hepatomegaly, acute severe hepatotoxicity, and fatal… | 13 sources — open the full entry |
| Lapatinib | Moderate | Metabolism | Coadministration with lapatinib may increase the plasma concentrations of drugs that are substrates of the CYP450 2C8 isoenzyme, CYP450 3A4 isoenzyme, and/or… | 6 sources — open the full entry |
| Lasmiditan Hemisuccinate | Moderate | Distribution | Coadministration with lasmiditan may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) and/or breast cancer… | 1 sources — open the full entry |
| Lefamulin Acetate | Moderate | Metabolism | When administered orally, lefamulin may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 3A4. Based on interaction with… | 6 sources — open the full entry |
| Lopinavir + Ritonavir | Moderate | Absorption | In vitro data suggest that coadministration with potent inhibitors of P-glycoprotein (e.g., cyclosporine) and/or organic anion transporting polypeptide (e.g… | 2 sources — open the full entry |
| Lorlatinib | Moderate | Metabolism | Coadministration with lorlatinib may decrease the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. The proposed mechanism is… | 3 sources — open the full entry |
| Mavacamten | Moderate | Metabolism | Coadministration with mavacamten may decrease the plasma concentrations of drugs that are primarily metabolized by CYP450 3A4, 2C9, and/or 2C19. The proposed… | 1 sources — open the full entry |
| Methotrexate | Moderate | Synergy | Coadministration of methotrexate with other agents known to induce hepatotoxicity may potentiate the risk of liver injury. Methotrexate, especially at higher… | 3 sources — open the full entry |
| Neratinib Maleate | Moderate | Others | Coadministration with neratinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 4 sources — open the full entry |
| Nilotinib | Moderate | Metabolism | Based on in vitro inhibition data, coadministration with nilotinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein… | 6 sources — open the full entry |
| Nirmatrelvir + Ritonavir | Moderate | Absorption | In vitro data suggest that coadministration with potent inhibitors of P-glycoprotein (e.g., cyclosporine) and/or organic anion transporting polypeptide (e.g… | 2 sources — open the full entry |
| Ospemifene | Moderate | Excretion | Ospemifene and its major metabolite, 4-hydroxyospemifene, may increase the plasma concentrations and the risk of adverse effects of drugs that are substrates… | 3 sources — open the full entry |
| Pentoxifylline | Moderate | Synergy | Pentoxifylline may potentiate the action of hypotensive agents. Small decreases in blood pressure have been observed in some patients treated with… | 1 sources — open the full entry |
| Ponatinib Hydrochloride | Moderate | Others | Based on in vitro inhibition data, coadministration with ponatinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein… | 2 sources — open the full entry |
Conditions
Conditions in which Ambrisentan needs care, as documented in this source.
Liver Failure
MajorEndothelin receptor antagonists (ERAs) have been associated with aminotransferase elevations, hepatotoxicity, and cases of liver failure. Hepatic function should be assessed before treatment initiation and closely monitored during treatment. Therapy should be discontinued if aminotransferase elevations are accompanied by increases in bilirubin, or clinical symptoms of hepatotoxicity such as nausea, vomiting, fever, abdominal pain or jaundice. Treatment should be avoided in patients with elevated aminotransferases at baseline as monitoring for hepatotoxicity may be more difficult. In general, the use of ERAs is not recommended for patients with moderate to severe hepatic impairment.
4 sources
- "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
- "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
- "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
- "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc. (2023):
Anemia
ModerateClinical studies have shown that most endothelin receptor antagonists decrease hemoglobin concentration and hematocrit levels. There are some postmarketing reports of anemia cases which needed blood transfusion. Hemoglobin and hematocrit levels should be measured prior to treatment initiation and should be monitored periodically thereafter. Initiation of therapy is not recommended in patients with clinically significant anemia.
3 sources
- "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
- "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
- "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
Kidney Diseases
ModerateThere is no information on the exposure to ambrisentan in patients with severe renal impairment. Additionally, the impact of hemodialysis on the disposition of ambrisentan has not been studied, hence caution is advised. No dosage adjustment is required in patients with mild or moderate renal impairment.
1 source
- "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
Water-Electrolyte Imbalance
ModeratePeripheral edema and fluid retention are known clinical consequences of pulmonary hypertension and also known effects of endothelin receptor antagonists. Caution and monitoring is recommended if these agents are used in patients with underlying left ventricular dysfunction or underlying heart failure, as they have an increased risk for developing significant fluid retention that may need treatment or require discontinuation.
4 sources
- "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
- "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
- "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
- "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc. (2023):
Therapeutic duplication
Drug classes that overlap with Ambrisentan, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
agents for pulmonary hypertensio
The recommended maximum number of medicines in the 'agents for pulmonary hypertension' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'agents for pulmonary hypertension' category.
Example product in the source data (US market): Finasteride/tadalafil