Ambrican
Ambrican is ambrisentan 5 mg tablets — selective endothelin-A receptor antagonist for pulmonary arterial hypertension (PAH). Originally Letairis/Volibris (Gilead/GSK 2007). ARIES-1/2 trials established PAH benefit; AMBITION (2015) supported upfront combination therapy with tadalafil. Less hepatotoxic than bosentan. PAH is specialist-managed, not ordinary systemic hypertension — all ERAs are strictly contraindicated in pregnancy (REMS programme in US).
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Ambrican?
Ambrican is 5 mg ambrisentan tablets from a WHO-GMP certified manufacturer — a selective endothelin receptor A antagonist (ERA) for pulmonary arterial hypertension (PAH). PAH is a specific, progressive, and rare disease — not the same as systemic hypertension. It raises pressure in the pulmonary arteries, not the systemic arteries, and requires dedicated specialist-directed therapy at an accredited PAH centre. Ambrisentan was introduced by Gilead/GSK in 2007 as Letairis (US) / Volibris (global). Selective for ETA over ETB receptors — theoretical advantage of preserving the ETB-mediated clearance and vasodilator pathway, though clinical superiority over non-selective ERAs (bosentan, macitentan) has not been definitively demonstrated. selectively blocks endothelin-A receptors on pulmonary arterial smooth muscle. Endothelin-1 is a potent vasoconstrictor and pro-fibrotic mediator upregulated in PAH; ERA blockade reduces pulmonary vascular resistance and pulmonary artery pressure, and slows disease progression. Dosing: Start 5 mg once daily; increase to 10 mg once daily at 4 weeks if tolerated. PAH treatment is typically combination therapy initiated and monitored at a specialist centre; this is not a DIY disease.
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What Is Ambrican?
Ambrican is 5 mg ambrisentan tablets from a WHO-GMP certified manufacturer, supplied in 30-90 tablets. Ambrisentan was introduced by Gilead/GSK in 2007 as Letairis (US) / Volibris (global). Selective for ETA over ETB receptors — theoretical advantage of preserving the ETB-mediated clearance and vasodilator pathway, though clinical superiority over non-selective ERAs (bosentan, macitentan) has not been definitively demonstrated.
Pulmonary arterial hypertension (PAH) is not systemic hypertension. PAH refers specifically to raised pressure in the pulmonary arterial circulation (≥20 mmHg mean pulmonary arterial pressure with pulmonary vascular resistance ≥2 Wood Units per 2022 ESC/ERS guidelines). It is rare (estimated 15-50 per million adults), progressive, and without treatment carries a poor prognosis (historical 5-year survival ∼30%). Modern PAH-targeted therapy has improved 5-year survival to 60-70% in expert centres.
Candidates for Ambrican have been diagnosed at a PAH specialist centre via right heart catheterisation, with WHO/NYHA functional class II-IV symptoms and confirmed PAH (WHO Group 1) or — for riociguat — inoperable or persistent CTEPH (WHO Group 4). This is not a drug for ordinary hypertension or for self-initiated therapy.
How Ambrisentan Works
Selectively blocks endothelin-A receptors on pulmonary arterial smooth muscle. Endothelin-1 is a potent vasoconstrictor and pro-fibrotic mediator upregulated in PAH; ERA blockade reduces pulmonary vascular resistance and pulmonary artery pressure, and slows disease progression.
Evidence
ARIES-1 and ARIES-2 (2008) — ambrisentan in 202 and 192 PAH patients respectively; 6-minute walk improved by 31-51 m vs placebo; WHO functional class improved; clinical worsening delayed. AMBITION (2015) — upfront ambrisentan + tadalafil reduced clinical failure by 50% vs either as monotherapy in treatment-naive PAH, establishing combination initial therapy as standard of care for moderate-severe PAH.
Dosage and Monitoring
Dosing: Start 5 mg once daily; increase to 10 mg once daily at 4 weeks if tolerated.
Monitoring: at baseline and every 3-6 months thereafter — WHO functional class, 6-minute walk distance, NT-proBNP, repeat echocardiography, and (at longer intervals) right heart catheterisation. All done through a specialist PAH centre.
Liver function: baseline LFTs, then every 1-3 months initially, then every 3-6 months. Discontinue if transaminases >3× ULN with symptoms or >5× ULN asymptomatic.
Side Effects
- Peripheral oedema (17-30%; higher than other ERAs)
- Hepatotoxicity (<1% with ambrisentan — lower than bosentan; LFT monitoring is less intensive than with bosentan)
- Anaemia — class effect
- Nasal congestion, flushing, headache
- Testicular atrophy and reduced sperm count (rare class effect)
- Pulmonary veno-occlusive disease unmasking — can precipitate life-threatening pulmonary oedema in misdiagnosed PVOD; assess carefully before starting.
Contraindications
- Pregnancy — absolute contraindication. All ERAs are teratogenic (craniofacial and cardiovascular malformations). US: REMS programme with monthly pregnancy testing and dual contraception; global: similar risk management programmes.
- Idiopathic pulmonary fibrosis (ERAs worsen IPF)
- Severe hepatic impairment (Child-Pugh B or C)
Frequently Asked Questions
Is pulmonary arterial hypertension the same as “high blood pressure”?
No. Systemic hypertension is raised pressure in the general circulation and is very common; PAH is raised pressure in the pulmonary circulation specifically and is rare. They have different causes, different specialists (PAH care is typically by pulmonology/cardiology teams at tertiary centres), and very different drug treatments. A drug that lowers systemic BP (ACEi, ARB, CCB, thiazide) usually has little effect on PAH.
Why does Ambrican require specialist monitoring?
PAH is a specialist-managed disease with a registry-based surveillance model in most countries. The drugs are expensive, have specific adverse effects (particularly hepatotoxicity for ERAs and hypotension for sGC stimulators), and dose-titration depends on serial assessments (6-minute walk, functional class, NT-proBNP, echocardiography). Off-label self-management carries high risks of clinical deterioration.
Can I take Ambrican with erectile dysfunction drugs?
Yes with caution. Ambrisentan + PDE5 inhibitor (sildenafil, tadalafil) is actually the AMBITION combination — standard of care for moderate-severe PAH. However, BP monitoring is important because both drugs lower systemic BP.
Can I take Ambrican in pregnancy?
No. All endothelin receptor antagonists are teratogenic (craniofacial and cardiovascular malformations). Monthly pregnancy testing and dual contraception are required during therapy; the same precautions are standard for bosentan and macitentan.
Where can I buy Ambrican online?
You can buy Ambrican (ambrisentan 5 mg, 30-90 tablets) from MedsBase with discreet packaging and worldwide shipping.
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More options in High Blood Pressure Medication
Ranked by recent MedsBase order volume — what other customers in this category are picking.
| Strength | 5 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s |
| Pharma Form | Tablet/s |
| Manufacturer | Lupin Ltd |
| Treatment | Pulmonary arterial hypertension (PAH) |
| Generic Brand | Ambrisentan |
Ambrican
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