Indications And Dose
Pulmonary arterial hypertension (initiated under specialist supervision) ▶BY MOUTH ▶Adult: 5 mg once daily, increased if necessary to 10 mg once daily
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Drug reference
Pulmonary arterial hypertension (initiated under specialist supervision) ▶BY MOUTH ▶Adult: 5 mg once daily, increased if necessary to 10 mg once daily
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DUE TO INTERACTIONS ▶Manufacturer advises max. dose 5 mg daily and close monitoring with concurrent use of ciclosporin.
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Idiopathic pulmonary fibrosis
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Not to be initiated in significant anaemia. pulmonary veno-occlusive disease
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Scottish Medicines Consortium (SMC) decisions SMC No. 511/08 The Scottish Medicines Consortium has advised (November 2008) that ambrisentan (Volibris ®) is accepted for restricted use within NHS Scotland for the treatment of patients with pulmonary arterial hypertension (PAH) classified as WHO functional class II and III, to improve exercise capacity, when prescribed by specialists in the Scottish Pulmonary Vascular Unit or similar specialists.
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→Appendix 1: ambrisentan
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▶Common or very common Abdominal pain. anaemia. asthenia. constipation. diarrhoea. dizziness. epistaxis. flushing. headaches. hypersensitivity. increased risk of infection. nasal congestion. nausea. palpitations. skin reactions. syncope. tinnitus. vision disorders. vomiting ▶Uncommon Hepatic disorders. sudden hearing loss
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Exclude pregnancy before treatment and ensure effective contraception during treatment. Monthly pregnancy tests advised.
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Avoid (teratogenic in animal studies).
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Manufacturer advises avoid—no information available.
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Manufacturer advises avoid in severe impairment or if baseline serum transaminases exceed 3 times the upper limit of normal.
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Use with caution if eGFR less than 30 mL/minute/1.73 m2.
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▶Monitor haemoglobin concentration or haematocrit after 1 month and 3 months of starting treatment, and periodically thereafter (reduce dose or discontinue treatment if significant decrease in haemoglobin concentration or haematocrit observed). ▶Monitor liver function before treatment, and monthly thereafter—discontinue if liver enzymes raised significantly or if symptoms of liver impairment develop.
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Volibris (GlaxoSmithKline UK Ltd) Ambrisentan 5 mg Volibris 5mg tablets | 30 tablet P £1,618.08 DT = £1,618.08 Ambrisentan 10 mg Volibris 10mg tablets | 30 tablet P £1,618.08 DT = £1,618.08
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Alert card A patient alert card should be provided.
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5 mg once daily, increased if necessary to 10 mg
First-line fragment. Read the complete Indications and Dose section above.
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