Drug interactions
Bosentan + Primidone
Severity: Moderate
Bosentan and Primidone: 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
Primidone is converted to phenobarbital, an enzyme inducer, and may therefore reduce bosentan exposure. Reduced efficacy in pulmonary arterial hypertension is possible, though specific clinical data are scarce.
What this interaction means in plain words
Bosentan and Primidone 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; Primidone belongs to Central Nervous System.
Why it happens
Primidone and its metabolite phenobarbital induce CYP3A4 and CYP2C9, increasing bosentan clearance.
What to do
Monitor clinical response of pulmonary hypertension and liver function when primidone is started or stopped. Consider an alternative anticonvulsant if bosentan response is lost.
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 Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Other interactions of Primidone
- Lorlatinib + Primidone Contraindicated
- Lurasidone + Primidone Contraindicated
- Primidone + Ranolazine Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Voriconazole Contraindicated
- Abiraterone + Primidone Major
Frequently asked questions
Can I take Bosentan with Primidone?
MediHelp rates the interaction as moderate. Bosentan and Primidone 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. Primidone is converted to phenobarbital, an enzyme inducer, and may therefore reduce bosentan exposure. Reduced efficacy in pulmonary arterial hypertension is possible, though specific clinical data are scarce.
How serious is the interaction between Bosentan and Primidone?
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 of pulmonary hypertension and liver function when primidone is started or stopped. Consider an alternative anticonvulsant if bosentan response is lost.
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.
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