Drug interactions
Bosentan + Ribociclib
Severity: Major
Bosentan and Ribociclib: major interaction.
Last updated Sources: US FDA label
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 induces CYP3A4 and may lower ribociclib exposure, potentially reducing anticancer efficacy. Ribociclib, a CYP3A4 inhibitor, may in turn raise bosentan levels, increasing the risk of hepatotoxicity and hypotension.
What this interaction means in plain words
Bosentan and Ribociclib 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; Ribociclib belongs to Oncology.
Why it happens
Bosentan is a moderate CYP3A4 inducer and ribociclib is a CYP3A4 inhibitor, with CYP3A4 involved in both drugs' metabolism.
What to do
Avoid the combination where possible; if unavoidable, monitor liver enzymes and blood pressure for bosentan toxicity and watch for loss of ribociclib effect. Consider an alternative pulmonary hypertension therapy.
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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
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 Ribociclib?
MediHelp rates the interaction as major. Bosentan and Ribociclib 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 induces CYP3A4 and may lower ribociclib exposure, potentially reducing anticancer efficacy. Ribociclib, a CYP3A4 inhibitor, may in turn raise bosentan levels, increasing the risk of hepatotoxicity and hypotension.
How serious is the interaction between Bosentan and Ribociclib?
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 the combination where possible; if unavoidable, monitor liver enzymes and blood pressure for bosentan toxicity and watch for loss of ribociclib effect. Consider an alternative pulmonary hypertension therapy.
What other medicines interact with Ribociclib?
MediHelp also lists interactions of Ribociclib with, for example, Amiodarone, Cisapride, Dofetilide. The full list is on the Ribociclib page.
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