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Drug interactions

Bosentan + Ethinyl estradiol-norgestimate

Severity: Major

Bosentan and Ethinyl estradiol-norgestimate: 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 induces CYP3A4 and can lower hormonal contraceptive exposure. Bosentan is teratogenic, so contraceptive failure is particularly harmful.

What this interaction means in plain words

Bosentan and Ethinyl estradiol-norgestimate 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-norgestimate belongs to Endocrine.

Evidence level: High

Why it happens

Induction of CYP3A4 increases metabolic clearance of the contraceptive hormones.

What to do

Do not rely on hormonal contraception alone; use two methods, or an IUD or tubal sterilization, as recommended by bosentan labeling.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Bosentan with Ethinyl estradiol-norgestimate?

MediHelp rates the interaction as major. Bosentan and Ethinyl estradiol-norgestimate 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. Bosentan is teratogenic, so contraceptive failure is particularly harmful.

How serious is the interaction between Bosentan and Ethinyl estradiol-norgestimate?

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; use two methods, or an IUD or tubal sterilization, as recommended by bosentan labeling.

What other medicines interact with Ethinyl estradiol-norgestimate?

MediHelp also lists interactions of Ethinyl estradiol-norgestimate with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-norgestimate page.

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