Drug interactions
Bosentan + Irinotecan
Severity: Moderate
Bosentan and Irinotecan: 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 may speed up the conversion of irinotecan and its active metabolite SN-38 to inactive products. This could lower exposure to the active drug and reduce antitumour efficacy.
What this interaction means in plain words
Bosentan and Irinotecan 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; Irinotecan belongs to Oncology.
Why it happens
Bosentan induces CYP3A4, increasing oxidative clearance of irinotecan and SN-38.
What to do
Prefer an alternative to bosentan where possible, or monitor tumour response and toxicity closely. Avoid combining with strong CYP3A4 inducers such as rifampicin or enzyme-inducing anticonvulsants.
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 Irinotecan
- Clozapine + Irinotecan Contraindicated
- Irinotecan + Sacituzumab govitecan Contraindicated
- Adenovirus types 4 and 7 live + Irinotecan Major
- Apalutamide + Irinotecan Major
- Atazanavir + Irinotecan Major
- Carbamazepine + Irinotecan 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 Irinotecan?
MediHelp rates the interaction as moderate. Bosentan and Irinotecan 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 may speed up the conversion of irinotecan and its active metabolite SN-38 to inactive products. This could lower exposure to the active drug and reduce antitumour efficacy.
How serious is the interaction between Bosentan and Irinotecan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative to bosentan where possible, or monitor tumour response and toxicity closely. Avoid combining with strong CYP3A4 inducers such as rifampicin or enzyme-inducing anticonvulsants.
What other medicines interact with Irinotecan?
MediHelp also lists interactions of Irinotecan with, for example, Clozapine, Sacituzumab govitecan, Adenovirus types 4 and 7 live. The full list is on the Irinotecan page.
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