Drug interactions
Bosentan + Ramelteon
Severity: Minor
Bosentan and Ramelteon: minor 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 inducer of CYP3A4 and CYP2C9 and may lower ramelteon exposure. Reduced sedative-hypnotic efficacy is possible, though the effect is not well characterized.
What this interaction means in plain words
Bosentan and Ramelteon have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Bosentan belongs to Miscellaneous; Ramelteon belongs to Central Nervous System.
Why it happens
Bosentan induces CYP3A4 and CYP2C9, increasing hepatic metabolism of ramelteon.
What to do
No routine dose change is needed; reassess insomnia control if bosentan is started and consider adjusting the hypnotic plan if efficacy is lost.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
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 Ramelteon?
MediHelp rates the interaction as minor. Bosentan and Ramelteon have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Bosentan is a moderate inducer of CYP3A4 and CYP2C9 and may lower ramelteon exposure. Reduced sedative-hypnotic efficacy is possible, though the effect is not well characterized.
How serious is the interaction between Bosentan and Ramelteon?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed; reassess insomnia control if bosentan is started and consider adjusting the hypnotic plan if efficacy is lost.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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