| Pulmonary arterial hypertension
Letairis vs Uptravi
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Letairis vs Uptravi with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsUptravi has a higher rate of injection site reactions vs Letairis based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Uptravi but not Letairis, including UnitedHealthcare
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Category
Letairis
Uptravi
At A Glance
Oral
Daily
Endothelin receptor antagonist
Oral / IV infusion
Twice daily
Prostacyclin receptor agonist
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 Starting dose 200 mcg orally twice daily; increase by 200 mcg twice daily at weekly intervals to the highest tolerated dose up to 1600 mcg twice daily. For moderate hepatic impairment (Child-Pugh class B), start at 200 mcg once daily and increase by 200 mcg once daily at weekly intervals. When co-administered with a moderate CYP2C8 inhibitor, reduce dosing to once daily. IV infusion (80-minute) is dosed twice daily at the corresponding tablet dose for patients temporarily unable to take oral therapy.
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)
- Hypersensitivity to selexipag or any excipient
- Concomitant use of strong CYP2C8 inhibitors (e.g., gemfibrozil)
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 (>=3%) Headache, diarrhea, nausea, vomiting, jaw pain, myalgia, pain in extremity, flushing, arthralgia, rash, anemia, decreased appetite
Postmarketing Symptomatic hypotension
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.
Selexipag is a prostacyclin receptor (IP receptor) agonist structurally distinct from prostacyclin; it is hydrolyzed by carboxylesterase 1 to an active metabolite approximately 37-fold more potent, selective for the IP receptor over other prostanoid receptors (EP1-4, DP, FP, and TP).
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Most Common Insurance
Anthem BCBS
Letairis
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
Uptravi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (10/12)
UnitedHealthcare
Letairis
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Uptravi
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Letairis
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Uptravi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$5/momo
Letairis Co-Pay Coupon ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
$5/fillfill
Janssen CarePath Oral PAH Savings Program: UptraviCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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LetairisView full Letairis profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.