Drug interactions
Bosentan + Hydrocodone
Severity: Moderate
Bosentan and Hydrocodone: 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 can lower hydrocodone exposure, reducing pain relief. After bosentan is stopped, hydrocodone concentrations may rise and cause respiratory depression.
What this interaction means in plain words
Bosentan and Hydrocodone 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; Hydrocodone belongs to Musculoskeletal.
Why it happens
CYP3A4 induction by bosentan increases hydrocodone clearance.
What to do
Monitor analgesic effect and adjust the hydrocodone dose. If bosentan is withdrawn, lower the hydrocodone dose and monitor for sedation and respiratory depression.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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone 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 Hydrocodone?
MediHelp rates the interaction as moderate. Bosentan and Hydrocodone 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 can lower hydrocodone exposure, reducing pain relief. After bosentan is stopped, hydrocodone concentrations may rise and cause respiratory depression.
How serious is the interaction between Bosentan and Hydrocodone?
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 effect and adjust the hydrocodone dose. If bosentan is withdrawn, lower the hydrocodone dose and monitor for sedation and respiratory depression.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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