Which side effect is commonly associated with both endothelin receptor antagonists (ERAs)?

Endothelin receptor antagonists (ERAs) are a class of medications primarily used in the management of pulmonary arterial hypertension (PAH). One notable side effect associated with ERAs is teratogenicity. These drugs have the potential to cause birth defects when administered to pregnant women, which makes it imperative for female patients of childbearing potential to be counseled on the importance of effective contraception while starting and continuing therapy with ERAs.

The teratogenic risk comes from the actions of endothelin-1, which plays a crucial role in fetal development. Consequently, ERAs block the effects of this peptide and can disrupt normal development in the fetus, particularly in achieving essential vascular developments. This risk is a central consideration in the prescribing information for these medications, supporting the need for strict pregnancy testing and contraceptive measures in female patients.

While other side effects such as gastrointestinal symptoms may be associated with ERAs, they are not specific to this class and can occur with various other medications as well. Similarly, vision changes and jaw pain are not well-established side effects related to ERAs. Therefore, the primary focus on teratogenicity underscores the importance of risk management in prescribing ERAs, making it the most relevant side effect associated with this