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Drug interactions

Bosentan + Pretomanid

Severity: Major

Bosentan and Pretomanid: 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

Pretomanid is partly metabolized by CYP3A4, and inducers can lower its exposure. This may compromise tuberculosis treatment efficacy.

What this interaction means in plain words

Bosentan and Pretomanid 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; Pretomanid belongs to Anti Bacterial.

Evidence level: Low

Why it happens

Bosentan induces CYP3A4, increasing pretomanid metabolism.

What to do

Avoid coadministration and use an alternative to bosentan during therapy. If unavoidable, monitor treatment response closely.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Bosentan with Pretomanid?

MediHelp rates the interaction as major. Bosentan and Pretomanid 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. Pretomanid is partly metabolized by CYP3A4, and inducers can lower its exposure. This may compromise tuberculosis treatment efficacy.

How serious is the interaction between Bosentan and Pretomanid?

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 coadministration and use an alternative to bosentan during therapy. If unavoidable, monitor treatment response closely.

What other medicines interact with Bosentan?

MediHelp also lists interactions of Bosentan with, for example, Cyclosporin, Cyclosporine, Glyburide. 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.

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