Drug interactions
Bosentan + Ethinyl estradiol-drospirenone
Severity: Major
Bosentan and Ethinyl estradiol-drospirenone: 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 reduce hormonal contraceptive exposure, so pills may not be reliable. Bosentan is teratogenic, so contraceptive failure is a serious concern.
What this interaction means in plain words
Bosentan and Ethinyl estradiol-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; Ethinyl estradiol-drospirenone belongs to Endocrine.
Why it happens
Bosentan induces CYP3A4 and CYP2C9, lowering contraceptive steroid levels.
What to do
Use two reliable methods, or an IUD or tubal sterilization, as per labeling, rather than relying on hormonal pills alone.
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 Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone 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 Ethinyl estradiol-drospirenone?
MediHelp rates the interaction as major. Bosentan and Ethinyl estradiol-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 can reduce hormonal contraceptive exposure, so pills may not be reliable. Bosentan is teratogenic, so contraceptive failure is a serious concern.
How serious is the interaction between Bosentan and Ethinyl estradiol-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: Use two reliable methods, or an IUD or tubal sterilization, as per labeling, rather than relying on hormonal pills alone.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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