title: Pharmacokinetic evaluation of ambrisentan.
abstract: BACKGROUND
  Pulmonary arterial hypertension (PAH) is a life-threatening and progressive disease characterized by increasing pulmonary vascular resistance leading to right ventricular failure and premature death. Current therapies target three major pathways involving endothelin, prostacyclin and NO. Ambrisentan is an oral, once daily, selective endothelin receptor antagonist.
  
  
  METHODS
  This review focuses on, and critically appraises, the clinical efficacy and safety of ambrisentan as well as its pharmacokinetic and pharmacodynamic properties. The article also gives an expert perspective on the role of ambrisentan in the management of PAH.
  
  
  CONCLUSIONS
  Ambrisentan is an effective and safe treatment which is, in the authors' opinion, a valuable addition to the armamentarium against PAH. Ambrisentan offers a relative lack of drug interactions, once daily dosing and reassuring liver safety, offering safety and convenience advantages over bosentan. Presently, there is a lack of comparative studies between PDE5 inhibitors and endothelin receptor antagonists and a lack of data comparing bosentan with ambrisentan. This is hindering data-based conclusions regarding relative efficacy and further studies are needed to define the role of ambrisentan in the management of PAH.
authors.affiliation: Banner Good Samaritan Medical Center, Department of Pharmacy, 1111 E. McDowell Rd, Phoenix, AZ 85006, USA.
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Buckley
authors.forename: Laura M
authors.initials: LM
authors.lastname: Wicks
authors.forename: Robin L
authors.initials: RL
authors.lastname: Staib
authors.forename: Anna K
authors.initials: AK
authors.lastname: Kirejczyk
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Varker
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Gibson
authors.forename: Jeremy P
authors.initials: JP
authors.lastname: Feldman
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000737:chemistry / Q000378:metabolism / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D065627:Familial Primary Pulmonary Hypertension; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D010666:Phenylpropionates / Q000737:chemistry / Q000378:metabolism / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use*; D011724:Pyridazines / Q000737:chemistry / Q000378:metabolism / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D010666:Phenylpropionates; D011724:Pyridazines; C467894:ambrisentan