Drug interactions
Bedaquiline + Bosentan
Severity: Moderate
Bedaquiline and Bosentan: moderate 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 may reduce bedaquiline concentrations through CYP3A4 induction, risking reduced antimycobacterial efficacy and resistance. The effect is expected to be smaller than with strong inducers such as rifampicin.
What this interaction means in plain words
Bedaquiline and Bosentan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Bedaquiline belongs to Anti Bacterial; Bosentan belongs to Miscellaneous.
Why it happens
CYP3A4 induction by bosentan increases bedaquiline clearance.
What to do
Avoid if alternatives exist; otherwise monitor sputum culture response closely.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Bedaquiline
- Bedaquiline + Ziprasidone Contraindicated
- Alfuzosin + Bedaquiline Major
- Amiodarone + Bedaquiline Major
- Amisulpride + Bedaquiline Major
- Amitriptyline + Bedaquiline Major
- Amobarbital + Bedaquiline Major
Frequently asked questions
Can I take Bedaquiline with Bosentan?
MediHelp rates the interaction as moderate. Bedaquiline and Bosentan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Bosentan may reduce bedaquiline concentrations through CYP3A4 induction, risking reduced antimycobacterial efficacy and resistance. The effect is expected to be smaller than with strong inducers such as rifampicin.
How serious is the interaction between Bedaquiline and Bosentan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if alternatives exist; otherwise monitor sputum culture response closely.
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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