Drug interactions
Bosentan + Diltiazem
Severity: Moderate
Bosentan and Diltiazem: 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
Diltiazem increases bosentan exposure, raising the risk of hepatotoxicity and hypotension, while bosentan may lower diltiazem levels over time.
What this interaction means in plain words
Bosentan and Diltiazem 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; Diltiazem belongs to Cardiovascular.
Why it happens
Diltiazem inhibits CYP3A4 metabolism of bosentan, and bosentan induces CYP3A4, lowering diltiazem.
What to do
Monitor liver enzymes, blood pressure and heart rate, and adjust diltiazem dosing if its effect diminishes.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem 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 Diltiazem?
MediHelp rates the interaction as moderate. Bosentan and Diltiazem 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. Diltiazem increases bosentan exposure, raising the risk of hepatotoxicity and hypotension, while bosentan may lower diltiazem levels over time.
How serious is the interaction between Bosentan and Diltiazem?
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 enzymes, blood pressure and heart rate, and adjust diltiazem dosing if its effect diminishes.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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