Drug interactions
Bosentan + Levonorgestrel
Severity: Major
Bosentan and Levonorgestrel: major 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 induces CYP3A4 and may lower systemic levonorgestrel exposure from oral or emergency products. The intrauterine system acts mainly locally and is much less affected, so the concern is mainly for systemic formulations, and bosentan is teratogenic.
What this interaction means in plain words
Bosentan and Levonorgestrel 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; Levonorgestrel belongs to Endocrine.
Why it happens
Bosentan induces CYP3A4, increasing the metabolism of levonorgestrel.
What to do
Use a reliable method that does not depend on systemic hormone levels, such as an intrauterine system or copper IUD, rather than oral levonorgestrel alone. Consider a higher emergency contraception dose or a copper IUD for emergency use.
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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Other interactions of Levonorgestrel
Other interactions of Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Cyclosporine Contraindicated
- Bosentan + Glyburide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
Frequently asked questions
Can I take Bosentan with Levonorgestrel?
MediHelp rates the interaction as major. Bosentan and Levonorgestrel 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 induces CYP3A4 and may lower systemic levonorgestrel exposure from oral or emergency products. The intrauterine system acts mainly locally and is much less affected, so the concern is mainly for systemic formulations, and bosentan is teratogenic.
How serious is the interaction between Bosentan and Levonorgestrel?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a reliable method that does not depend on systemic hormone levels, such as an intrauterine system or copper IUD, rather than oral levonorgestrel alone. Consider a higher emergency contraception dose or a copper IUD for emergency use.
What other medicines interact with Levonorgestrel?
MediHelp also lists interactions of Levonorgestrel with, for example, Amobarbital, Apalutamide, Belzutifan. The full list is on the Levonorgestrel page.
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