Drug interactions
Bosentan + Ethotoin
Severity: Moderate
Bosentan and Ethotoin: 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
Bosentan induces some CYP enzymes and could lower exposure to hydantoin anticonvulsants such as ethotoin. The effect is largely extrapolated from phenytoin, and a loss of seizure control is possible. Hydantoins may in turn lower bosentan levels.
What this interaction means in plain words
Bosentan and Ethotoin 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
Bosentan induces CYP2C9 and CYP3A4, which may increase the clearance of ethotoin; the data for ethotoin itself are limited.
What to do
Monitor seizure control and ethotoin concentrations if available when bosentan is started or stopped, and adjust the dose accordingly.
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 Ethotoin?
MediHelp rates the interaction as moderate. Bosentan and Ethotoin 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 induces some CYP enzymes and could lower exposure to hydantoin anticonvulsants such as ethotoin. The effect is largely extrapolated from phenytoin, and a loss of seizure control is possible. Hydantoins may in turn lower bosentan levels.
How serious is the interaction between Bosentan and Ethotoin?
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 seizure control and ethotoin concentrations if available when bosentan is started or stopped, and adjust the dose accordingly.
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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