Drug interactions
Bosentan + Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate
Severity: Major
Bosentan and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate: 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
Bosentan may reduce hormonal contraceptive concentrations and effectiveness, risking unintended pregnancy. Bosentan is teratogenic, so contraceptive failure is particularly serious.
What this interaction means in plain words
Bosentan and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate 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.
Why it happens
Bosentan induces CYP3A4, increasing metabolism of ethinylestradiol and levonorgestrel.
What to do
Do not rely on hormonal contraception alone; use a reliable alternative such as an IUD or tubal sterilization, or two methods together, as required by bosentan labeling.
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?
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References
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 Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate?
MediHelp rates the interaction as major. Bosentan and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate 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 may reduce hormonal contraceptive concentrations and effectiveness, risking unintended pregnancy. Bosentan is teratogenic, so contraceptive failure is particularly serious.
How serious is the interaction between Bosentan and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not rely on hormonal contraception alone; use a reliable alternative such as an IUD or tubal sterilization, or two methods together, as required by bosentan labeling.
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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