Drug interactions
Amiodarone + Macitentan
Severity: Major
Amiodarone and Macitentan: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amiodarone inhibits CYP3A4 and CYP2C9 and is predicted to substantially raise macitentan levels. Because of its long half-life the effect persists after discontinuation.
What this interaction means in plain words
Amiodarone and Macitentan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Macitentan belongs to Cardiovascular.
Why it happens
Combined CYP3A4 and CYP2C9 inhibition by amiodarone decreases macitentan clearance.
What to do
Avoid if possible; otherwise monitor for hypotension, anemia and liver injury, recognizing prolonged amiodarone effect.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Macitentan
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Macitentan?
MediHelp rates the interaction as major. Amiodarone and Macitentan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Amiodarone inhibits CYP3A4 and CYP2C9 and is predicted to substantially raise macitentan levels. Because of its long half-life the effect persists after discontinuation.
How serious is the interaction between Amiodarone and Macitentan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; otherwise monitor for hypotension, anemia and liver injury, recognizing prolonged amiodarone effect.
What other medicines interact with Macitentan?
MediHelp also lists interactions of Macitentan with, for example, Apalutamide, Bosentan, Carbamazepine. The full list is on the Macitentan page.
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