Drug interactions
Bosentan + Chloramphenicol
Severity: Moderate
Bosentan and Chloramphenicol: 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
Chloramphenicol inhibits CYP3A4 and may raise bosentan concentrations, which increases the risk of dose-related hepatotoxicity and other adverse effects. Bosentan is a CYP3A4 and CYP2C9 substrate, so exposure can increase with inhibition.
What this interaction means in plain words
Bosentan and Chloramphenicol 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 belongs to Miscellaneous; Chloramphenicol belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4-mediated metabolism of bosentan by chloramphenicol.
What to do
Monitor liver aminotransferases and signs of bosentan toxicity such as hypotension and edema during co-administration. Use an alternative antibiotic if feasible.
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 Chloramphenicol
Other interactions of Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Frequently asked questions
Can I take Bosentan with Chloramphenicol?
MediHelp rates the interaction as moderate. Bosentan and Chloramphenicol 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. Chloramphenicol inhibits CYP3A4 and may raise bosentan concentrations, which increases the risk of dose-related hepatotoxicity and other adverse effects. Bosentan is a CYP3A4 and CYP2C9 substrate, so exposure can increase with inhibition.
How serious is the interaction between Bosentan and Chloramphenicol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor liver aminotransferases and signs of bosentan toxicity such as hypotension and edema during co-administration. Use an alternative antibiotic if feasible.
What other medicines interact with Chloramphenicol?
MediHelp also lists interactions of Chloramphenicol with, for example, Adagrasib, Avapritinib, Bcg vaccine live. The full list is on the Chloramphenicol page.
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