Drug interactions
Bosentan + Vandetanib
Severity: Major
Bosentan and Vandetanib: 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
Bosentan is a moderate CYP3A4 inducer and may lower vandetanib plasma exposure, possibly reducing its antitumor effect. Vandetanib also prolongs the QT interval, and bosentan is not a recognized QT-prolonging drug, so the concern here is mainly loss of efficacy.
What this interaction means in plain words
Bosentan and Vandetanib 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; Vandetanib belongs to Oncology.
Why it happens
Induction of CYP3A4 by bosentan increases vandetanib metabolism and lowers its exposure.
What to do
Avoid the combination where possible and use an alternative to bosentan. If it cannot be avoided, monitor tumor response and ECG/QT and electrolytes closely.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Bosentan and Vandetanib, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Vandetanib
- Amiodarone + Vandetanib Contraindicated
- Amisulpride + Vandetanib Contraindicated
- Amitriptyline + Vandetanib Contraindicated
- Anagrelide + Vandetanib Contraindicated
- Asenapine + Vandetanib Contraindicated
- Chloroquine + Vandetanib Contraindicated
Frequently asked questions
Can I take Bosentan with Vandetanib?
MediHelp rates the interaction as major. Bosentan and Vandetanib 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 is a moderate CYP3A4 inducer and may lower vandetanib plasma exposure, possibly reducing its antitumor effect. Vandetanib also prolongs the QT interval, and bosentan is not a recognized QT-prolonging drug, so the concern here is mainly loss of efficacy.
How serious is the interaction between Bosentan and Vandetanib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use an alternative to bosentan. If it cannot be avoided, monitor tumor response and ECG/QT and electrolytes closely.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
