Drug interactions
Bosentan + Dienogest / estradiol valerate
Severity: Major
Bosentan and Dienogest / estradiol valerate: major interaction.
Last updated Sources: US FDA label
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 can lower hormonal contraceptive levels, reducing contraceptive efficacy. This matters because bosentan is teratogenic and pregnancy must be avoided.
What this interaction means in plain words
Bosentan and Dienogest / estradiol valerate 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.
Why it happens
CYP3A4 induction by bosentan accelerates metabolism of dienogest and estradiol.
What to do
Do not rely on this product as contraception; use an effective non-hormonal method such as an IUD or combine methods, and continue pregnancy testing per 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
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 Dienogest / estradiol valerate?
MediHelp rates the interaction as major. Bosentan and Dienogest / estradiol valerate 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 can lower hormonal contraceptive levels, reducing contraceptive efficacy. This matters because bosentan is teratogenic and pregnancy must be avoided.
How serious is the interaction between Bosentan and Dienogest / estradiol valerate?
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 this product as contraception; use an effective non-hormonal method such as an IUD or combine methods, and continue pregnancy testing per bosentan labeling.
What other medicines interact with Bosentan?
MediHelp also lists interactions of Bosentan with, for example, Cyclosporin, Glibenclamide, Glyburide-metformin. The full list is on the Bosentan page.
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