Drug interactions
Bosentan + Tacrolimus
Severity: Moderate
Bosentan and Tacrolimus: 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 induces CYP3A4 and may lower tacrolimus blood concentrations. Subtherapeutic levels can increase the risk of graft rejection.
What this interaction means in plain words
Bosentan and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Bosentan induces CYP3A4 and possibly P-glycoprotein, increasing tacrolimus clearance.
What to do
Monitor tacrolimus trough concentrations when starting or stopping bosentan and adjust the tacrolimus dose accordingly.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus 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 Tacrolimus?
MediHelp rates the interaction as moderate. Bosentan and Tacrolimus 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 induces CYP3A4 and may lower tacrolimus blood concentrations. Subtherapeutic levels can increase the risk of graft rejection.
How serious is the interaction between Bosentan and Tacrolimus?
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 tacrolimus trough concentrations when starting or stopping bosentan and adjust the tacrolimus dose accordingly.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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