Drug interactions
Bosentan + Efavirenz
Severity: Moderate
Bosentan and Efavirenz: 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
Efavirenz is a CYP3A4 inducer and bosentan is metabolised by CYP3A4 and CYP2C9, so bosentan exposure is more likely to fall than rise. Altered bosentan levels could change efficacy or hepatotoxicity risk.
What this interaction means in plain words
Bosentan and Efavirenz 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; Efavirenz belongs to Anti Virals.
Why it happens
Efavirenz modulates CYP3A4 and CYP2C9, altering bosentan metabolism, with induction likely predominating.
What to do
Monitor clinical response in pulmonary hypertension and liver function tests regularly.
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 Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
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 Efavirenz?
MediHelp rates the interaction as moderate. Bosentan and Efavirenz 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. Efavirenz is a CYP3A4 inducer and bosentan is metabolised by CYP3A4 and CYP2C9, so bosentan exposure is more likely to fall than rise. Altered bosentan levels could change efficacy or hepatotoxicity risk.
How serious is the interaction between Bosentan and Efavirenz?
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 clinical response in pulmonary hypertension and liver function tests regularly.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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