Drug interactions
Bosentan + Fludrocortisone
Severity: Moderate
Bosentan and Fludrocortisone: 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 CYP3A4 inducer and may increase the metabolism of fludrocortisone, lowering its mineralocorticoid effect. Patients with adrenal insufficiency could have inadequate sodium retention and blood pressure control.
What this interaction means in plain words
Bosentan and Fludrocortisone 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; Fludrocortisone belongs to Endocrine.
Why it happens
Bosentan induces CYP3A4, increasing hepatic clearance of fludrocortisone.
What to do
Monitor blood pressure, serum sodium and potassium and symptoms of hypoadrenalism after bosentan is started. Increase the fludrocortisone dose if the response is inadequate.
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 Fludrocortisone
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 Fludrocortisone?
MediHelp rates the interaction as moderate. Bosentan and Fludrocortisone 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 CYP3A4 inducer and may increase the metabolism of fludrocortisone, lowering its mineralocorticoid effect. Patients with adrenal insufficiency could have inadequate sodium retention and blood pressure control.
How serious is the interaction between Bosentan and Fludrocortisone?
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 blood pressure, serum sodium and potassium and symptoms of hypoadrenalism after bosentan is started. Increase the fludrocortisone dose if the response is inadequate.
What other medicines interact with Fludrocortisone?
MediHelp also lists interactions of Fludrocortisone with, for example, Mifepristone, Aldesleukin, Amphotericin b. The full list is on the Fludrocortisone page.
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