Drug interactions
Bosentan + Erythromycin ethylsuccinate
Severity: Moderate
Bosentan and Erythromycin ethylsuccinate: 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
Erythromycin inhibits CYP3A4 and can increase bosentan exposure, raising the risk of liver toxicity, hypotension and edema. Bosentan's own effect on erythromycin is minor.
What this interaction means in plain words
Bosentan and Erythromycin ethylsuccinate 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.
Why it happens
Erythromycin inhibits CYP3A4-mediated bosentan metabolism.
What to do
Monitor liver enzymes and blood pressure during erythromycin courses; consider a non-CYP3A-inhibiting antibiotic such as azithromycin.
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 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 Erythromycin ethylsuccinate?
MediHelp rates the interaction as moderate. Bosentan and Erythromycin ethylsuccinate 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. Erythromycin inhibits CYP3A4 and can increase bosentan exposure, raising the risk of liver toxicity, hypotension and edema. Bosentan's own effect on erythromycin is minor.
How serious is the interaction between Bosentan and Erythromycin ethylsuccinate?
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 and blood pressure during erythromycin courses; consider a non-CYP3A-inhibiting antibiotic such as azithromycin.
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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