Drug interactions
Bosentan + Fentanyl
Severity: Moderate
Bosentan and Fentanyl: 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 is a moderate CYP3A4 inducer and may lower fentanyl concentrations, reducing pain relief or precipitating withdrawal in dependent patients. If bosentan is stopped, fentanyl levels can rise and increase the risk of respiratory depression.
What this interaction means in plain words
Bosentan and Fentanyl 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 belongs to Miscellaneous; Fentanyl belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4-mediated fentanyl metabolism by bosentan.
What to do
Monitor analgesic response and withdrawal symptoms and titrate fentanyl as needed. If bosentan is stopped, reduce the fentanyl dose and watch for sedation and respiratory depression.
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 Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl 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 Fentanyl?
MediHelp rates the interaction as moderate. Bosentan and Fentanyl 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 is a moderate CYP3A4 inducer and may lower fentanyl concentrations, reducing pain relief or precipitating withdrawal in dependent patients. If bosentan is stopped, fentanyl levels can rise and increase the risk of respiratory depression.
How serious is the interaction between Bosentan and Fentanyl?
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 analgesic response and withdrawal symptoms and titrate fentanyl as needed. If bosentan is stopped, reduce the fentanyl dose and watch for sedation and respiratory depression.
What other medicines interact with Fentanyl?
MediHelp also lists interactions of Fentanyl with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Fentanyl page.
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