Drug interactions
Bosentan + Letermovir
Severity: Moderate
Bosentan and Letermovir: 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
Letermovir inhibits OATP1B1/3 and may increase bosentan plasma concentrations. It also has complex CYP3A inhibitory and CYP2C9/19 inducing effects. Higher bosentan exposure raises the risk of liver injury, hypotension and edema.
What this interaction means in plain words
Bosentan and Letermovir 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; Letermovir belongs to Anti Virals.
Why it happens
Letermovir inhibits hepatic OATP1B1/3 uptake of bosentan and inhibits CYP3A4.
What to do
Monitor liver aminotransferases, blood pressure and fluid status, and reduce bosentan dosing if adverse effects emerge.
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 Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Other interactions of Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Bosentan with Letermovir?
MediHelp rates the interaction as moderate. Bosentan and Letermovir 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. Letermovir inhibits OATP1B1/3 and may increase bosentan plasma concentrations. It also has complex CYP3A inhibitory and CYP2C9/19 inducing effects. Higher bosentan exposure raises the risk of liver injury, hypotension and edema.
How serious is the interaction between Bosentan and Letermovir?
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 aminotransferases, blood pressure and fluid status, and reduce bosentan dosing if adverse effects emerge.
What other medicines interact with Bosentan?
MediHelp also lists interactions of Bosentan with, for example, Cyclosporin, Glibenclamide, Glyburide-metformin. The full list is on the Bosentan page.
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