Drug interactions
Bosentan + Isosorbide mononitrate
Severity: Minor
Bosentan and Isosorbide mononitrate: minor 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 CYP3A4 inducer, but isosorbide mononitrate is cleared mainly by denitration and glucuronidation rather than CYP3A4. A clinically meaningful change in nitrate effect is therefore unlikely.
What this interaction means in plain words
Bosentan and Isosorbide mononitrate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Bosentan belongs to Miscellaneous; Isosorbide mononitrate belongs to Cardiovascular.
Why it happens
Theoretical CYP3A4 induction by bosentan; isosorbide mononitrate is not substantially CYP3A4 dependent.
What to do
No dose adjustment is needed; monitor anginal control as usual.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Isosorbide mononitrate
- Avanafil + Isosorbide mononitrate Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Sildenafil Contraindicated
- Isosorbide mononitrate + Tadalafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Ergotamine + Isosorbide mononitrate 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 Isosorbide mononitrate?
MediHelp rates the interaction as minor. Bosentan and Isosorbide mononitrate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Bosentan is a CYP3A4 inducer, but isosorbide mononitrate is cleared mainly by denitration and glucuronidation rather than CYP3A4. A clinically meaningful change in nitrate effect is therefore unlikely.
How serious is the interaction between Bosentan and Isosorbide mononitrate?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No dose adjustment is needed; monitor anginal control as usual.
What other medicines interact with Isosorbide mononitrate?
MediHelp also lists interactions of Isosorbide mononitrate with, for example, Avanafil, Riociguat, Sildenafil. The full list is on the Isosorbide mononitrate page.
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