Drug interactions
Bosentan + Clozapine
Severity: Minor
Bosentan and Clozapine: minor 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 CYP3A4 inducer and may modestly lower clozapine concentrations, which could reduce its efficacy. CYP1A2 is the main pathway for clozapine, so the effect is probably small.
What this interaction means in plain words
Bosentan and Clozapine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Bosentan belongs to Miscellaneous; Clozapine belongs to Central Nervous System.
Why it happens
Bosentan induces CYP3A4, increasing a secondary clearance pathway of clozapine.
What to do
Monitor for reduced psychiatric response when bosentan is started. Check clozapine levels if relapse is suspected.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
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 Clozapine?
MediHelp rates the interaction as minor. Bosentan and Clozapine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Bosentan is a CYP3A4 inducer and may modestly lower clozapine concentrations, which could reduce its efficacy. CYP1A2 is the main pathway for clozapine, so the effect is probably small.
How serious is the interaction between Bosentan and Clozapine?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced psychiatric response when bosentan is started. Check clozapine levels if relapse is suspected.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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