Drug interactions
Bosentan + Cholic acid
Severity: Major
Bosentan and Cholic acid: 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 inhibits the bile salt export pump, which can cause accumulation of bile salts in hepatocytes. Together with cholic acid, this may worsen liver injury.
What this interaction means in plain words
Bosentan and Cholic acid 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 belongs to Miscellaneous; Cholic acid belongs to Gastrointestinal Tract.
Why it happens
Bosentan inhibits BSEP, impairing biliary bile salt efflux.
What to do
Avoid the combination when possible; if used, monitor serum transaminases and bilirubin frequently and stop if liver injury develops.
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
Other interactions of Cholic acid
Frequently asked questions
Can I take Bosentan with Cholic acid?
MediHelp rates the interaction as major. Bosentan and Cholic acid 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 inhibits the bile salt export pump, which can cause accumulation of bile salts in hepatocytes. Together with cholic acid, this may worsen liver injury.
How serious is the interaction between Bosentan and Cholic acid?
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 when possible; if used, monitor serum transaminases and bilirubin frequently and stop if liver injury develops.
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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