Drug interactions
Artemether / lumefantrine + Bosentan
Severity: Major
Artemether / lumefantrine and Bosentan: 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
Bosentan is a moderate CYP3A4 inducer and may lower artemether and lumefantrine concentrations, which could cause antimalarial treatment failure. Bosentan itself is a CYP3A4 substrate and levels may be affected as well.
What this interaction means in plain words
Artemether / lumefantrine and Bosentan 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.
Why it happens
CYP3A4 induction by bosentan increases the metabolism of artemether and lumefantrine.
What to do
Avoid the combination if possible; if malaria treatment is urgent, give full-course therapy and monitor for treatment failure and follow-up parasitemia.
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 Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Cyclosporine Contraindicated
- Bosentan + Glyburide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Bosentan?
MediHelp rates the interaction as major. Artemether / lumefantrine and Bosentan 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. Bosentan is a moderate CYP3A4 inducer and may lower artemether and lumefantrine concentrations, which could cause antimalarial treatment failure. Bosentan itself is a CYP3A4 substrate and levels may be affected as well.
How serious is the interaction between Artemether / lumefantrine and Bosentan?
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 the combination if possible; if malaria treatment is urgent, give full-course therapy and monitor for treatment failure and follow-up parasitemia.
What other medicines interact with Bosentan?
MediHelp also lists interactions of Bosentan with, for example, Cyclosporin, Cyclosporine, Glyburide. The full list is on the Bosentan page.
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