Drug interactions
Bosentan + Rivaroxaban
Severity: Moderate
Bosentan and Rivaroxaban: 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
Bosentan is a moderate CYP3A4 inducer and may lower rivaroxaban exposure, potentially reducing its protective effect against thrombosis. The magnitude is likely modest.
What this interaction means in plain words
Bosentan and Rivaroxaban 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; Rivaroxaban belongs to Cardiovascular.
Why it happens
Induction of CYP3A4 (and possibly P-gp) by bosentan increases rivaroxaban clearance.
What to do
Monitor for signs of thromboembolism or loss of anticoagulant effect. Consider an alternative anticoagulant if the indication carries high thrombotic risk.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
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 Rivaroxaban?
MediHelp rates the interaction as moderate. Bosentan and Rivaroxaban 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 is a moderate CYP3A4 inducer and may lower rivaroxaban exposure, potentially reducing its protective effect against thrombosis. The magnitude is likely modest.
How serious is the interaction between Bosentan and Rivaroxaban?
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 for signs of thromboembolism or loss of anticoagulant effect. Consider an alternative anticoagulant if the indication carries high thrombotic risk.
What other medicines interact with Rivaroxaban?
MediHelp also lists interactions of Rivaroxaban with, for example, Defibrotide, Ketoconazole, Ketorolac. The full list is on the Rivaroxaban page.
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