| Pulmonary arterial hypertension

Letairis vs Revatio

Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.

Deep comparison between: Letairis vs Revatio with Prescriber.AI

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Safety signalsRevatio has a higher rate of injection site reactions vs Letairis based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Revatio but not Letairis, including UnitedHealthcare

Category

Letairis

Revatio

At A Glance

RouteOral

FrequencyDaily

ClassEndothelin receptor antagonist

RouteOral or IV bolus

FrequencyThree times a day

ClassPDE-5 inhibitor

Indications

Pulmonary arterial hypertension

Pulmonary arterial hypertension

Dosing

Pulmonary arterial hypertension Initiate at 5 mg once daily, with or without tadalafil 20 mg once daily; titrate at 4-week intervals as needed and tolerated to Letairis 10 mg or tadalafil 40 mg; do not split, crush, or chew tablets.

Pulmonary arterial hypertension Adults: 20 mg orally three times a day (may titrate to 80 mg three times a day) or 10 mg IV bolus three times a day; pediatric patients <=20 kg: 10 mg orally three times a day; 20-45 kg: 20 mg three times a day; >45 kg: 20 mg three times a day (may titrate to 40 mg three times a day).

Contraindications

Pregnancy (Letairis may cause fetal harm when administered to a pregnant female)
Idiopathic Pulmonary Fibrosis, including IPF patients with pulmonary hypertension (WHO Group 3)

Concomitant use of organic nitrates in any form, either regularly or intermittently, due to risk of hypotension
Concomitant use of riociguat, a guanylate cyclase stimulator
Known hypersensitivity to sildenafil or any component of the tablet, injection, or oral suspension

Drug Interactions

1116View drug interactions

1152View drug interactions

Adverse Reactions

Most common (>3% placebo-adjusted) Peripheral edema, nasal congestion, sinusitis, flushing

Postmarketing Anemia requiring transfusion, heart failure (associated with fluid retention), symptomatic hypotension, hypersensitivity (angioedema, rash), liver aminotransferase elevations (ALT, AST)

Most common (>=10%) Headache, flushing, pain in limb, myalgia, back pain, dyspepsia, diarrhea

Serious Hypotension, vision loss, hearing loss, priapism, vaso-occlusive crisis

Postmarketing Myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, pulmonary hemorrhage, seizure, NAION

Pharmacology

Ambrisentan is a high-affinity, selective ETA receptor antagonist that blocks the vasoconstriction and cell proliferation mediated by endothelin-1 (ET-1) in pulmonary vasculature, where ET-1 concentrations and mRNA are markedly elevated in PAH patients.

Sildenafil is a selective inhibitor of cGMP-specific PDE-5 in pulmonary vascular smooth muscle; by blocking PDE-5-mediated cGMP degradation, it elevates cGMP levels resulting in relaxation and vasodilation of the pulmonary vascular bed in patients with PAH.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Letairis