Drug interactions
Bosentan + Desogestrel-ethinyl estradiol
Severity: Major
Bosentan and Desogestrel-ethinyl estradiol: major interaction.
Last updated Sources: UK SmPC
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 induces CYP3A4 and can reduce hormonal contraceptive exposure, risking contraceptive failure. Because bosentan is teratogenic, pregnancy prevention is particularly important.
What this interaction means in plain words
Bosentan and Desogestrel-ethinyl estradiol 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; Desogestrel-ethinyl estradiol belongs to Endocrine.
Why it happens
CYP3A4 induction by bosentan reduces concentrations of ethinyl estradiol and progestin.
What to do
Do not rely on hormonal contraceptives alone; use a copper IUD or tubal sterilization, or combine two other methods as recommended in bosentan labeling.
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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References
- Bosentan 125 mg Film-coated Tablets - SmPC sections 4.3/4.5 (class statement: Hormonal contraceptives; "Hormonal contraceptives:") — electronic medicines compendium (UK SmPC)
Other interactions of Desogestrel-ethinyl estradiol
- Desogestrel-ethinyl estradiol + Fezolinetant Contraindicated
- Aminocaproic acid + Desogestrel-ethinyl estradiol Major
- Amobarbital + Desogestrel-ethinyl estradiol Major
- Anastrozole + Desogestrel-ethinyl estradiol Major
- Apalutamide + Desogestrel-ethinyl estradiol Major
- Atazanavir + Desogestrel-ethinyl estradiol 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 Desogestrel-ethinyl estradiol?
MediHelp rates the interaction as major. Bosentan and Desogestrel-ethinyl estradiol 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 induces CYP3A4 and can reduce hormonal contraceptive exposure, risking contraceptive failure. Because bosentan is teratogenic, pregnancy prevention is particularly important.
How serious is the interaction between Bosentan and Desogestrel-ethinyl estradiol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not rely on hormonal contraceptives alone; use a copper IUD or tubal sterilization, or combine two other methods as recommended in bosentan labeling.
What other medicines interact with Desogestrel-ethinyl estradiol?
MediHelp also lists interactions of Desogestrel-ethinyl estradiol with, for example, Fezolinetant, Aminocaproic acid, Amobarbital. The full list is on the Desogestrel-ethinyl estradiol page.
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