Drug interactions
Bosentan + Itraconazole
Severity: Major
Bosentan and Itraconazole: major interaction.
Last updated Sources: US FDA label
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
Itraconazole can raise bosentan concentrations, increasing the risk of hepatotoxicity, edema and anemia. Bosentan, a CYP3A4 inducer, may in turn lower itraconazole levels and reduce antifungal efficacy.
What this interaction means in plain words
Bosentan and Itraconazole 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.
Bosentan belongs to Miscellaneous; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole inhibits CYP3A4-mediated bosentan metabolism, while bosentan induces CYP3A4 and lowers itraconazole exposure.
What to do
Monitor liver function closely and consider avoiding the combination. If used, check itraconazole levels and clinical response to the antifungal.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Bosentan and Itraconazole, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
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 Itraconazole?
MediHelp rates the interaction as major. Bosentan and Itraconazole 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. Itraconazole can raise bosentan concentrations, increasing the risk of hepatotoxicity, edema and anemia. Bosentan, a CYP3A4 inducer, may in turn lower itraconazole levels and reduce antifungal efficacy.
How serious is the interaction between Bosentan and Itraconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor liver function closely and consider avoiding the combination. If used, check itraconazole levels and clinical response to the antifungal.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
