Drug Interactions in Pulmonary Arterial Hypertension and Their Implications

Medical intervention is necessary in the treatment of pulmonary arterial hypertension (PAH) in order to prevent chronic disease progression and clinical deterioration. Recent years have seen the development of new disease-specific drugs, such as endothelin receptor antagonists (ERAs). However, there remains the potential for drug–drug interactions (DDIs), which can adversely affect drug metabolism and therefore treatment efficacy, an especially significant factor to consider in light of the increasing use of combination therapy in PAH and the ageing patient population who may also suffer age-related diseases requiring concomitant drug therapy. The ERA ambrisentan has demonstrated lower liver toxicity and fewer DDIs than other ERAs. The lack of any significant drug interactions with commonly used adjunct therapies such as warfarin or sildenafil could potentially improve treatment efficacy as well as patient safety.