Drug interactions
Bosentan + Glecaprevir / pibrentasvir
Severity: Major
Bosentan and Glecaprevir / pibrentasvir: major 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
Glecaprevir inhibits OATP1B1/3 and may raise bosentan levels, increasing the risk of hepatotoxicity and hypotension. Bosentan, as a CYP3A4 inducer, may lower glecaprevir/pibrentasvir exposure and risk hepatitis C treatment failure.
What this interaction means in plain words
Bosentan and Glecaprevir / pibrentasvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Glecaprevir inhibits OATP1B1/3 uptake of bosentan, while bosentan induces CYP3A4 and may lower glecaprevir/pibrentasvir concentrations.
What to do
Avoid if possible; if used together, monitor liver enzymes and blood pressure, and consider bosentan dose adjustment while viral response is followed.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Glecaprevir / pibrentasvir?
MediHelp rates the interaction as major. Bosentan and Glecaprevir / pibrentasvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Glecaprevir inhibits OATP1B1/3 and may raise bosentan levels, increasing the risk of hepatotoxicity and hypotension. Bosentan, as a CYP3A4 inducer, may lower glecaprevir/pibrentasvir exposure and risk hepatitis C treatment failure.
How serious is the interaction between Bosentan and Glecaprevir / pibrentasvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; if used together, monitor liver enzymes and blood pressure, and consider bosentan dose adjustment while viral response is followed.
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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