Drug interactions
Bosentan + Lumacaftor / ivacaftor
Severity: Moderate
Bosentan and Lumacaftor / ivacaftor: 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
Lumacaftor/ivacaftor is itself a strong CYP3A inducer and can reduce bosentan levels, and bosentan may reduce ivacaftor exposure. Both effects could diminish efficacy.
What this interaction means in plain words
Bosentan and Lumacaftor / ivacaftor 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.
Why it happens
Opposing CYP3A4 induction: lumacaftor lowers bosentan exposure and bosentan may lower ivacaftor exposure.
What to do
Monitor for reduced response to either drug, including pulmonary arterial hypertension symptoms and CF outcomes, and adjust therapy as clinically required.
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
Frequently asked questions
Can I take Bosentan with Lumacaftor / ivacaftor?
MediHelp rates the interaction as moderate. Bosentan and Lumacaftor / ivacaftor 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. Lumacaftor/ivacaftor is itself a strong CYP3A inducer and can reduce bosentan levels, and bosentan may reduce ivacaftor exposure. Both effects could diminish efficacy.
How serious is the interaction between Bosentan and Lumacaftor / ivacaftor?
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 for reduced response to either drug, including pulmonary arterial hypertension symptoms and CF outcomes, and adjust therapy as clinically required.
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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