Drug interactions
Bosentan + Rifabutin
Severity: Moderate
Bosentan and Rifabutin: 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
Rifabutin induces CYP3A4 and CYP2C9 and can lower bosentan exposure, risking reduced pulmonary hypertension control. Bosentan may also modestly reduce rifabutin levels via induction, risking reduced antimycobacterial effect.
What this interaction means in plain words
Bosentan and Rifabutin 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; Rifabutin belongs to Anti Bacterial.
Why it happens
Mutual induction of CYP3A4 (and CYP2C9) metabolism.
What to do
Monitor clinical response and functional status for bosentan efficacy, and monitor for rifabutin treatment response or levels. Adjust doses as needed.
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 Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Bosentan with Rifabutin?
MediHelp rates the interaction as moderate. Bosentan and Rifabutin 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. Rifabutin induces CYP3A4 and CYP2C9 and can lower bosentan exposure, risking reduced pulmonary hypertension control. Bosentan may also modestly reduce rifabutin levels via induction, risking reduced antimycobacterial effect.
How serious is the interaction between Bosentan and Rifabutin?
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 and functional status for bosentan efficacy, and monitor for rifabutin treatment response or levels. Adjust doses as needed.
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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