Drug interactions
Bosentan + Fluvoxamine
Severity: Moderate
Bosentan and Fluvoxamine: 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 metabolized by CYP2C9 and CYP3A4, and fluvoxamine inhibits CYP2C9 moderately and CYP3A4 weakly, so bosentan levels may increase. This could raise the risk of liver enzyme elevations, headache and fluid retention.
What this interaction means in plain words
Bosentan and Fluvoxamine 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; Fluvoxamine belongs to Central Nervous System.
Why it happens
Fluvoxamine inhibits CYP2C9 and CYP3A4, reducing bosentan clearance.
What to do
Monitor liver function tests per bosentan labeling and watch for edema and hypotension; consider an alternative antidepressant if hepatic tests rise.
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 Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
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 Fluvoxamine?
MediHelp rates the interaction as moderate. Bosentan and Fluvoxamine 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 metabolized by CYP2C9 and CYP3A4, and fluvoxamine inhibits CYP2C9 moderately and CYP3A4 weakly, so bosentan levels may increase. This could raise the risk of liver enzyme elevations, headache and fluid retention.
How serious is the interaction between Bosentan and Fluvoxamine?
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 liver function tests per bosentan labeling and watch for edema and hypotension; consider an alternative antidepressant if hepatic tests rise.
What other medicines interact with Fluvoxamine?
MediHelp also lists interactions of Fluvoxamine with, for example, Agomelatine, Alosetron, Fezolinetant. The full list is on the Fluvoxamine page.
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