Drug interactions
Bosentan + Tipranavir
Severity: Major
Bosentan and Tipranavir: major 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
Tipranavir with ritonavir inhibits CYP3A4 and may increase bosentan exposure, raising risk of hepatotoxicity and hypotension. Bosentan may also lower protease inhibitor levels.
What this interaction means in plain words
Bosentan and Tipranavir 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; Tipranavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted tipranavir inhibits CYP3A4 and OATP, reducing bosentan clearance, while bosentan induces CYP3A4.
What to do
Follow the ritonavir-type strategy: hold bosentan at least 36 hours before starting the protease inhibitor and restart after about 10 days at 62.5 mg once daily or every other day. Monitor liver enzymes, blood pressure and HIV viral load.
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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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 Tipranavir
- Alfuzosin + Tipranavir Contraindicated
- Amiodarone + Tipranavir Contraindicated
- Atorvastatin + Tipranavir Contraindicated
- Avanafil + Tipranavir Contraindicated
- Cisapride + Tipranavir Contraindicated
- Colchicine + Tipranavir Contraindicated
Frequently asked questions
Can I take Bosentan with Tipranavir?
MediHelp rates the interaction as major. Bosentan and Tipranavir 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. Tipranavir with ritonavir inhibits CYP3A4 and may increase bosentan exposure, raising risk of hepatotoxicity and hypotension. Bosentan may also lower protease inhibitor levels.
How serious is the interaction between Bosentan and Tipranavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Follow the ritonavir-type strategy: hold bosentan at least 36 hours before starting the protease inhibitor and restart after about 10 days at 62.5 mg once daily or every other day. Monitor liver enzymes, blood pressure and HIV viral load.
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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