Drug interactions
Bosentan + Midazolam
Severity: Moderate
Bosentan and Midazolam: 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
Bosentan induces CYP3A4 and can reduce midazolam concentrations, potentially weakening sedative or anxiolytic effect. The effect is more pronounced with oral midazolam.
What this interaction means in plain words
Bosentan and Midazolam 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; Midazolam belongs to Central Nervous System.
Why it happens
Induction of CYP3A4 by bosentan increases midazolam metabolism.
What to do
Monitor clinical response and titrate midazolam to effect, anticipating higher dose needs. Consider IV rather than oral dosing if reliable effect is 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 Midazolam
- Atazanavir + Midazolam Contraindicated
- Cobicistat + Midazolam Contraindicated
- Darunavir + Midazolam Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Midazolam Contraindicated
- Fosamprenavir + Midazolam Contraindicated
- Indinavir + Midazolam 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 Midazolam?
MediHelp rates the interaction as moderate. Bosentan and Midazolam 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 induces CYP3A4 and can reduce midazolam concentrations, potentially weakening sedative or anxiolytic effect. The effect is more pronounced with oral midazolam.
How serious is the interaction between Bosentan and Midazolam?
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 clinical response and titrate midazolam to effect, anticipating higher dose needs. Consider IV rather than oral dosing if reliable effect is required.
What other medicines interact with Midazolam?
MediHelp also lists interactions of Midazolam with, for example, Atazanavir, Cobicistat, Darunavir. The full list is on the Midazolam page.
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