Drug interactions
Bosentan + Fosaprepitant
Severity: Moderate
Bosentan and Fosaprepitant: 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
Fosaprepitant is converted to aprepitant, a CYP3A4 substrate. Bosentan may lower aprepitant concentrations, which could reduce antiemetic protection. Aprepitant is also a moderate CYP3A4 inhibitor and may raise bosentan levels.
What this interaction means in plain words
Bosentan and Fosaprepitant 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; Fosaprepitant belongs to Gastrointestinal Tract.
Why it happens
Bosentan induces CYP3A4 and increases aprepitant clearance.
What to do
Monitor for breakthrough nausea and vomiting, and consider additional antiemetics if control 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 Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Other interactions of Fosaprepitant
- Flibanserin + Fosaprepitant Contraindicated
- Fosaprepitant + Pimozide Contraindicated
- Alprazolam + Fosaprepitant Moderate
- Amiodarone + Fosaprepitant Moderate
- Amobarbital + Fosaprepitant Moderate
- Apalutamide + Fosaprepitant Moderate
Frequently asked questions
Can I take Bosentan with Fosaprepitant?
MediHelp rates the interaction as moderate. Bosentan and Fosaprepitant 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. Fosaprepitant is converted to aprepitant, a CYP3A4 substrate. Bosentan may lower aprepitant concentrations, which could reduce antiemetic protection. Aprepitant is also a moderate CYP3A4 inhibitor and may raise bosentan levels.
How serious is the interaction between Bosentan and Fosaprepitant?
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 for breakthrough nausea and vomiting, and consider additional antiemetics if control is inadequate.
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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