Bosentan has 46 known drug interactions based on U.S. FDA drug labeling data. Of these, 4 are contraindicated combinations that should be avoided entirely. 17 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Glibenclamide, Glyburide And Metformin Hydrochloride, Glyburide-Metformin Hydrochloride. Patients taking Bosentan should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 46
- Contraindicated
- 4
- Major
- 17
- Moderate
- 25
Contraindicated (4)
- Bosentan + Glibenclamide— Concomitant administration of glyburide and bosentan is contraindicated due to increased risk of liver enzyme elevations…
- Bosentan + Glyburide And Metformin Hydrochloride— Concomitant administration is contraindicated due to increased risk of liver enzyme elevations.
- Bosentan + Glyburide-Metformin Hydrochloride— Concomitant administration is contraindicated due to increased risk of liver enzyme elevations.
- Bosentan + Lemborexant— Moderate CYP3A inducer that decreases lemborexant exposure, which may reduce DAYVIGO efficacy. Concomitant use should be…
Major (17)
- Bosentan + Amiodarone— As a CYP2C9 inhibitor, amiodarone combined with a strong or moderate CYP3A inhibitor will likely lead to large increases…
- Bosentan + Amprenavir— Moderate CYP3A inhibitor; when combined with a CYP2C9 inhibitor, will likely lead to large increases in bosentan plasma …
- Bosentan + Diltiazem— Moderate CYP3A inhibitor; when combined with a CYP2C9 inhibitor, will likely lead to large increases in bosentan plasma …
- Bosentan + Erythromycin— Moderate CYP3A inhibitor; when combined with a CYP2C9 inhibitor, will likely lead to large increases in bosentan plasma …
- Bosentan + Ethinyl Estradiol— Bosentan decreases ethinyl estradiol exposure by average of 31%, with decreases up to 66% in individual subjects, reduci…
- Bosentan + Fluconazole— As a CYP2C9 inhibitor, fluconazole combined with a strong or moderate CYP3A inhibitor will likely lead to large increase…
- Bosentan + Itraconazole— Strong CYP3A inhibitor; when combined with a CYP2C9 inhibitor, will likely lead to large increases in bosentan plasma co…
- Bosentan + Ketoconazole— Strong CYP3A inhibitor; when combined with a CYP2C9 inhibitor, will likely lead to large increases in bosentan plasma co…
- Bosentan + Lurasidone Hydrochloride— Moderate CYP3A4 inducer decreases lurasidone exposure. Lurasidone dose should be increased.
- Bosentan + Macimorelin Acetate— Strong CYP3A4 inducer may reduce plasma macimorelin concentrations and lead to false positive test results. Discontinue …
- Bosentan + Medroxyprogesterone Acetate— Moderate CYP3A inducer may decrease medroxyprogesterone acetate concentrations and reduce contraceptive efficacy. Avoid …
- Bosentan + Norethindrone— Bosentan decreases norethindrone exposure by average of 14%, with decreases up to 56% in individual subjects, reducing h…
- Bosentan + Norethindrone Acetate/Ethinyl Estradiol— May decrease contraceptive effectiveness and increase breakthrough bleeding through CYP3A4 induction.
- Bosentan + Norgestimate And Ethinyl Estradiol— May decrease plasma concentrations of COCs and potentially diminish effectiveness or increase breakthrough bleeding.
- Bosentan + Oral Contraceptives— Bosentan reduces effectiveness of oral, injectable, transdermal, and implantable hormonal contraceptives by decreasing e…
- Bosentan + Warfarin— CYP2C9 inducer that decreases warfarin exposure and INR; requires close INR monitoring.
- Bosentan + Warfarin Sodium— CYP2C9 inducer that decreases warfarin effect and INR; requires closer INR monitoring.
Moderate (25)
- Bosentan + Axitinib— Moderate CYP3A4/5 inducer may reduce axitinib plasma exposure and should be avoided if possible.
- Bosentan + Cyclosporine— Decreases cyclosporine concentrations; appropriate dosage adjustment required.
- Bosentan + Desogestrel And Ethinyl Estradiol And Ethinyl Estradiol— Induces CYP3A4 and may decrease plasma concentrations of desogestrel and ethinyl estradiol, potentially diminishing cont…
- Bosentan + Drospirenone— May decrease systemic concentrations of hormonal contraceptives and diminish effectiveness or increase breakthrough blee…
- Bosentan + Drospirenone And Ethinyl Estradiol— Induces CYP3A4 enzyme, may decrease effectiveness of COCs or increase breakthrough bleeding.
- Bosentan + Drospirenone, Ethinyl Estradiol And Levomefolate Calcium And Levomefolate Calcium— May decrease the effectiveness of hormonal contraceptives or increase breakthrough bleeding through CYP3A4 enzyme induct…
- Bosentan + Drospirenone/Ethinyl Estradiol/Levomefolate Calcium And Levomefolate Calcium— Enzyme inducer that may decrease effectiveness of COCs or increase breakthrough bleeding. Use back-up contraception.
- Bosentan + Eltrombopag— OATP1B1 substrate; eltrombopag may increase exposure. Monitor closely and consider dose reduction if appropriate.
- Bosentan + Eltrombopag Olamine— OATP1B1 substrate; monitor for excessive exposure and consider dose reduction if appropriate.
- Bosentan + Estradiol Valerate And Estradiol Valerate/Dienogest— CYP3A4 enzyme inducer that may decrease the effectiveness of the contraceptive or increase breakthrough bleeding.
- Bosentan + Etonogestrel— May decrease plasma concentrations of etonogestrel and diminish contraceptive effectiveness or increase breakthrough ble…
- Bosentan + Etonogestrel And Ethinyl Estradiol— CYP3A4 enzyme inducer that may decrease plasma concentrations of etonogestrel and ethinyl estradiol, potentially diminis…
- Bosentan + Etonogestrel And Ethinyl Estradiol Vaginal Ring— Induces CYP3A4, may decrease plasma concentrations of CHCs and potentially diminish effectiveness or increase breakthrou…
- Bosentan + Gemfibrozil— OATP1B1 substrate; gemfibrozil inhibition may increase bosentan exposure, requiring dosing reduction.
- Bosentan + Levonorgestrel And Ethinyl Estradiol And Ethinyl Estradiol Tablets— Bosentan induces CYP3A4 and may decrease plasma concentrations of COCs, potentially diminishing contraceptive effectiven…
- Bosentan + Levonorgestrel And Ethinyl Estradiol And Ferrous Fumarate— Bosentan induces CYP3A4 enzymes, potentially decreasing contraceptive effectiveness and increasing breakthrough bleeding…
- Bosentan + Levonorgestrel/Ethinyl Estradiol And Ethinyl Estradiol— Enzyme inducer that may decrease plasma concentrations of contraceptive hormones and reduce effectiveness of hormonal co…
- Bosentan + Norelgestromin And Ethinyl Estradiol— Enzyme inducer that may decrease plasma concentrations of CHCs and potentially diminish effectiveness or increase breakt…
- Bosentan + Norethindrone Acetate, Ethinyl Estradiol And Ferrous Fumarate— CYP3A4 inducer that may decrease the effectiveness of COCs or increase breakthrough bleeding.
- Bosentan + Norethindrone And Ethinyl Estradiol— Enzyme inducer that may decrease plasma concentrations of norethindrone and ethinyl estradiol, potentially diminishing c…
- Bosentan + Norgestrel And Ethinyl Estradiol— May decrease plasma concentrations and efficacy of contraceptive; may increase breakthrough bleeding.
- Bosentan + Segesterone Acetate And Ethinyl Estradiol— Metabolic enzyme inducer that may decrease systemic concentrations of estrogen and/or progestin, potentially diminishing…
- Bosentan + Sildenafil— Concomitant use decreases sildenafil exposure. Dose up-titration of sildenafil may be needed when initiating treatment.
- Bosentan + Sildenafil Citrate— Bosentan decreases sildenafil exposure; dose up-titration of sildenafil may be needed when initiating treatment.
- Bosentan + Ulipristal Acetate— CYP3A4 inducer decreases plasma concentrations of ulipristal acetate and may decrease its effectiveness as emergency con…