Drug interactions
Bosentan + Tofacitinib
Severity: Moderate
Bosentan and Tofacitinib: 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 tofacitinib exposure, potentially reducing its efficacy. Bosentan is a moderate inducer, so the effect is likely smaller than with rifampicin.
What this interaction means in plain words
Bosentan and Tofacitinib 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; Tofacitinib belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 by bosentan increases tofacitinib metabolism.
What to do
Monitor disease control and consider a higher tofacitinib dose or alternative therapy if response is lost.
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 Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib 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 Tofacitinib?
MediHelp rates the interaction as moderate. Bosentan and Tofacitinib 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 tofacitinib exposure, potentially reducing its efficacy. Bosentan is a moderate inducer, so the effect is likely smaller than with rifampicin.
How serious is the interaction between Bosentan and Tofacitinib?
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 disease control and consider a higher tofacitinib dose or alternative therapy if response is lost.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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