HF 6718

Pulmonary Arterial Hypertension Medicines - Endothelin Receptor Antagonists: Bosentan (Tracleer®) and Ambrisentan (Letairis®) Macitentan (Opsumit®)

The name of your medicine is: ____________________________.

Bosentan (Tracleer®), Ambrisentan (Letairis®), and Macitentan (Opsumit®) are medicines used to manage Pulmonary Arterial Hypertension (PAH).

They help your blood vessels in the body to open. This may help to lower the overall pressure in your blood vessels and decrease how hard your heart has to work. Both men and women with PAH can use this type of medicine as long as there are no other medical reasons that would prevent its use. 

Do not take these medicines if you are or wish to become pregnant. 

If you have concerns or you want more information about your medicine and its use, check with your doctor, pharmacist or nurse.  

Please keep this and all other medicines out of the reach of children. Do not share your medicines with other people.  

Before You Use This Medicine

Tell your doctor, pharmacist or nurse if you:

  • Have liver disease.

  • Are or may become pregnant.

  • Have congestive heart failure.

  • Take any other medicines. 

  • Have leg or ankle swelling.

  • Have a blood disorder.

  • Are allergic to Bosentan, Ambrisentan or Macitentan.

How to Use

Take these medicines by mouth and as told by your doctor. 

You can take this medicine with or without food. Do not crush, break, or chew the tablets.

If you need to start new medicines while taking this medicine, be sure to talk with your doctor, pharmacist or nurse first.

Important to Know

You may need routine lab tests while taking this medicine. If you are a female of childbearing age, you will need to have a pregnancy test each month so that you can safely use this medicine. You may be asked to use two forms of birth control while taking this medicine. Birth control pills alone may not be enough to prevent pregnancy. This medicine can decrease how effective birth control pills are.

Common Dosing

Bosentan (Tracleer®)

62.5 mg by mouth twice a day for 4 weeks, then 125 mg by mouth twice a day after that. 

Ambrisentan (Letairis®)

5 mg by mouth once a day; may increase to 10 mg once a day if you tolerate 5 mg dose.  

Macitentan (Opsumit®)

10 mg by mouth once a day.

Side Effects 

Call your doctor right away if you have:

  • An allergic reaction(s) such as rash, hives, itchiness, swelling

  • Dizziness or fainting

  • Yellowing of skin or whites of eyes

  • Swelling (in ankles and legs)

  • An irregular heartbeat or chest pain

  • Nausea or vomiting

  • Confirmed you are pregnant or you think you may be pregnant (even if you take birth control pills)

  • A urinary tract infection

It is possible to have side effects that do not need to be treated. These may go away over time, but if they persist or bother you, check with your doctor, pharmacist or nurse before you stop the medicine. 

These include:

  • Headache

  • Flushing (warmth or redness in your face, neck, arms or upper chest)

  • Stuffy or runny nose 

  • Dry mouth

  • Heartburn

  • Diarrhea

  • Anxiety

If you have any other effects not listed, check with your doctor, pharmacist, or nurse.  

Tell your doctor right away if you think or learn that you are pregnant (even if you take birth control pills, wear a birth control patch, or have an IUD in place).

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.