Drug interactions
Bosentan + Ethinylestradiol
Severity: Major
Bosentan and Ethinylestradiol: 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 ethinylestradiol exposure, so hormonal contraception may be less reliable. This matters because bosentan is teratogenic and pregnancy must be prevented.
What this interaction means in plain words
Bosentan and Ethinylestradiol 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.
Why it happens
Bosentan induces CYP3A4 and increases the metabolism of ethinylestradiol and the co-administered progestin.
What to do
Do not rely on hormonal contraceptives alone during bosentan therapy. Use an intrauterine device or tubal sterilization, or combine two methods including a barrier method.
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 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 Ethinylestradiol?
MediHelp rates the interaction as major. Bosentan and Ethinylestradiol 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 ethinylestradiol exposure, so hormonal contraception may be less reliable. This matters because bosentan is teratogenic and pregnancy must be prevented.
How serious is the interaction between Bosentan and Ethinylestradiol?
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 contraceptives alone during bosentan therapy. Use an intrauterine device or tubal sterilization, or combine two methods including a barrier method.
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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