macitentan + tadalafil

**Macitentan + tadalafil** is an oral fixed-dose combination of two small-molecule pulmonary arterial hypertension therapies: macitentan, a dual endothelin receptor antagonist, and tadalafil, a phosphodiesterase type 5 inhibitor. It is marketed as **Opsynvi** in the United States and **Yuvanci** in the European Union for chronic treatment or substitution treatment of adults with World Health Organization Group 1 pulmonary arterial hypertension and functional class II–III symptoms. The combination concurrently suppresses endothelin-mediated pulmonary vasoconstriction and increases nitric oxide–cGMP signaling, promoting pulmonary vasodilation and reducing pulmonary vascular resistance. ([accessdata.fda.gov](https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/218490s002lbl.pdf))

Brand names

OpsynviYuvanci

Other names

M/T FDCM/T STCTmacitentan and tadalafilmacitentan/tadalafil