Drug interactions
Bosentan + Clarithromycin
Severity: Moderate
Bosentan and Clarithromycin: 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
Clarithromycin can increase bosentan concentrations, raising the risk of dose-related hepatotoxicity, headache, flushing and hypotension. Bosentan may in turn lower clarithromycin exposure through CYP3A4 induction, potentially reducing antibacterial efficacy.
What this interaction means in plain words
Bosentan and Clarithromycin 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; Clarithromycin belongs to Anti Bacterial.
Why it happens
Clarithromycin inhibits CYP3A4-mediated bosentan metabolism, while bosentan is a CYP3A4 inducer.
What to do
Monitor liver function tests and blood pressure during co-therapy, and watch for signs of reduced antibiotic response. Consider an alternative antibiotic for prolonged courses.
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 Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
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 Clarithromycin?
MediHelp rates the interaction as moderate. Bosentan and Clarithromycin 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. Clarithromycin can increase bosentan concentrations, raising the risk of dose-related hepatotoxicity, headache, flushing and hypotension. Bosentan may in turn lower clarithromycin exposure through CYP3A4 induction, potentially reducing antibacterial efficacy.
How serious is the interaction between Bosentan and Clarithromycin?
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 function tests and blood pressure during co-therapy, and watch for signs of reduced antibiotic response. Consider an alternative antibiotic for prolonged courses.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
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