Drug interactions
Bosentan + Leflunomide
Severity: Moderate
Bosentan and Leflunomide: 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
Leflunomide and bosentan are both hepatotoxic, so combining them may increase the risk of liver injury. A pharmacokinetic effect on bosentan via CYP2C9 is not well established.
What this interaction means in plain words
Bosentan and Leflunomide 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; Leflunomide belongs to Musculoskeletal.
Why it happens
Additive hepatotoxicity; teriflunomide may weakly inhibit CYP2C9, which metabolizes bosentan.
What to do
Monitor liver function tests regularly during coadministration. Stop or change therapy if transaminases rise significantly.
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 Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live 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 Leflunomide?
MediHelp rates the interaction as moderate. Bosentan and Leflunomide 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. Leflunomide and bosentan are both hepatotoxic, so combining them may increase the risk of liver injury. A pharmacokinetic effect on bosentan via CYP2C9 is not well established.
How serious is the interaction between Bosentan and Leflunomide?
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 liver function tests regularly during coadministration. Stop or change therapy if transaminases rise significantly.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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