Drug interactions
Bosentan + Rifapentine
Severity: Moderate
Bosentan and Rifapentine: 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
Rifapentine induces CYP3A4 and CYP2C9 and is expected to reduce bosentan exposure, as seen with rifampicin. The result may be reduced efficacy in pulmonary arterial hypertension. Bosentan levels may also rise transiently at initiation of rifamycins with rifampicin, adding uncertainty.
What this interaction means in plain words
Bosentan and Rifapentine 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; Rifapentine belongs to Anti Bacterial.
Why it happens
Rifapentine induces CYP3A4 and CYP2C9, increasing bosentan metabolism.
What to do
Monitor clinical response and liver aminotransferases when rifapentine is started or stopped. Consider adjusting therapy if pulmonary hypertension worsens.
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 Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Bosentan with Rifapentine?
MediHelp rates the interaction as moderate. Bosentan and Rifapentine 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. Rifapentine induces CYP3A4 and CYP2C9 and is expected to reduce bosentan exposure, as seen with rifampicin. The result may be reduced efficacy in pulmonary arterial hypertension. Bosentan levels may also rise transiently at initiation of rifamycins with rifampicin, adding uncertainty.
How serious is the interaction between Bosentan and Rifapentine?
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 liver aminotransferases when rifapentine is started or stopped. Consider adjusting therapy if pulmonary hypertension worsens.
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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