Drug interactions
Bosentan + Mifepristone
Severity: Major
Bosentan and Mifepristone: 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
Mifepristone may raise bosentan concentrations, increasing the risk of hepatotoxicity, headache and hypotension. Bosentan is also an inducer that can lower mifepristone exposure.
What this interaction means in plain words
Bosentan and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
Mifepristone inhibits CYP3A4, reducing bosentan metabolism, while bosentan induces CYP3A4.
What to do
Avoid concurrent use where possible. If used, monitor liver enzymes and blood pressure and consider reducing the bosentan dose.
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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone 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 Mifepristone?
MediHelp rates the interaction as major. Bosentan and Mifepristone 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. Mifepristone may raise bosentan concentrations, increasing the risk of hepatotoxicity, headache and hypotension. Bosentan is also an inducer that can lower mifepristone exposure.
How serious is the interaction between Bosentan and Mifepristone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible. If used, monitor liver enzymes and blood pressure and consider reducing the bosentan dose.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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