Drug interactions
Bosentan + Pimavanserin
Severity: Moderate
Bosentan and Pimavanserin: 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 is a moderate CYP3A4 inducer and may lower pimavanserin exposure, potentially reducing antipsychotic effect in Parkinson's disease psychosis. Strong inducers are labeled to be avoided, and moderate inducers can have a similar but smaller effect.
What this interaction means in plain words
Bosentan and Pimavanserin 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; Pimavanserin belongs to Central Nervous System.
Why it happens
Bosentan induces CYP3A4, increasing pimavanserin metabolism.
What to do
Monitor for loss of psychosis control and consider increasing the pimavanserin dose if efficacy declines.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Bosentan and Pimavanserin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Other interactions of Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Bosentan with Pimavanserin?
MediHelp rates the interaction as moderate. Bosentan and Pimavanserin 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 is a moderate CYP3A4 inducer and may lower pimavanserin exposure, potentially reducing antipsychotic effect in Parkinson's disease psychosis. Strong inducers are labeled to be avoided, and moderate inducers can have a similar but smaller effect.
How serious is the interaction between Bosentan and Pimavanserin?
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 loss of psychosis control and consider increasing the pimavanserin dose if efficacy declines.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
