Drug interactions
Bosentan + Nevirapine
Severity: Major
Bosentan and Nevirapine: major interaction.
Last updated Sources: UK SmPC
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 is a CYP3A4 and CYP2C9 inducer and may lower nevirapine concentrations. Bosentan exposure may also change, and hepatotoxicity risk is a concern with both drugs.
What this interaction means in plain words
Bosentan and Nevirapine 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; Nevirapine belongs to Anti Virals.
Why it happens
Bosentan induces CYP3A4 and CYP2B6, increasing nevirapine clearance, and both drugs are hepatotoxic.
What to do
Monitor HIV viral load and liver enzymes closely, and consider nevirapine concentrations. Consider an alternative antiretroviral if control is lost.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
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 Nevirapine?
MediHelp rates the interaction as major. Bosentan and Nevirapine 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 is a CYP3A4 and CYP2C9 inducer and may lower nevirapine concentrations. Bosentan exposure may also change, and hepatotoxicity risk is a concern with both drugs.
How serious is the interaction between Bosentan and Nevirapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor HIV viral load and liver enzymes closely, and consider nevirapine concentrations. Consider an alternative antiretroviral if control is lost.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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