Drug interactions
Bosentan + Drospirenone
Severity: Major
Bosentan and Drospirenone: major 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 induces CYP3A4 and can lower hormonal contraceptive exposure, reducing contraceptive reliability. This is the opposite of the legacy direction, and drospirenone does not meaningfully affect bosentan.
What this interaction means in plain words
Bosentan and Drospirenone 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; Drospirenone belongs to Endocrine.
Why it happens
Bosentan induces CYP3A4, increasing the metabolism of drospirenone and other contraceptive steroids.
What to do
Do not rely on hormonal contraception alone during bosentan therapy; add or switch to a reliable non-hormonal method such as an intrauterine device or use dual methods.
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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Other interactions of Drospirenone
Other interactions of Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Cyclosporine Contraindicated
- Bosentan + Glyburide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
Frequently asked questions
Can I take Bosentan with Drospirenone?
MediHelp rates the interaction as major. Bosentan and Drospirenone 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 lower hormonal contraceptive exposure, reducing contraceptive reliability. This is the opposite of the legacy direction, and drospirenone does not meaningfully affect bosentan.
How serious is the interaction between Bosentan and Drospirenone?
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 contraception alone during bosentan therapy; add or switch to a reliable non-hormonal method such as an intrauterine device or use dual methods.
What other medicines interact with Drospirenone?
MediHelp also lists interactions of Drospirenone with, for example, Belzutifan, Carbamazepine, Eplerenone. The full list is on the Drospirenone page.
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