Vanrafia Disease Interactions

Endothelin receptor antagonists (ERAs) have been associated with aminotransferase elevations, hepatotoxicity, and cases of liver failure. Hepatic function should be assessed before treatment initiation and closely monitored during treatment. Therapy should be discontinued if aminotransferase elevations are accompanied by increases in bilirubin, or clinical symptoms of hepatotoxicity such as nausea, vomiting, fever, abdominal pain or jaundice. Treatment should be avoided in patients with elevated aminotransferases at baseline as monitoring for hepatotoxicity may be more difficult. In general, the use of ERAs is not recommended for patients with moderate to severe hepatic impairment.

Use of atrasentan may cause fluid retention (e.g., peripheral edema). Atrasentan has not been studied in patients with primary immunoglobulin A nephropathy with heart failure. If clinically significant fluid retention develops, consider initiating/increasing diuretic treatment and interrupting therapy with atrasentan.