Drug interactions
Bosentan + Voxelotor
Severity: Moderate
Bosentan and Voxelotor: 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 voxelotor exposure, reducing its ability to prevent hemoglobin S polymerization. Voxelotor in turn inhibits CYP3A4 and may raise concentrations of sensitive CYP3A4 substrates, but bosentan is not a sensitive substrate of major concern. The net effect is mainly a risk of reduced voxelotor efficacy.
What this interaction means in plain words
Bosentan and Voxelotor 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; Voxelotor belongs to Miscellaneous.
Why it happens
Bosentan induces CYP3A4 and increases voxelotor clearance, while voxelotor weakly inhibits CYP3A4 and may modestly raise bosentan levels.
What to do
Avoid the combination where possible; if it is necessary, increase the voxelotor dose as directed in its labeling and monitor hemoglobin and clinical response. Monitor for bosentan adverse effects such as liver enzyme elevation and edema.
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 Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Other interactions of Voxelotor
- Amobarbital + Voxelotor Major
- Apalutamide + Voxelotor Major
- Carbamazepine + Voxelotor Major
- Cyclosporin + Voxelotor Major
- Efavirenz + Voxelotor Major
- Enzalutamide + Voxelotor Major
Frequently asked questions
Can I take Bosentan with Voxelotor?
MediHelp rates the interaction as moderate. Bosentan and Voxelotor 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 voxelotor exposure, reducing its ability to prevent hemoglobin S polymerization. Voxelotor in turn inhibits CYP3A4 and may raise concentrations of sensitive CYP3A4 substrates, but bosentan is not a sensitive substrate of major concern. The net effect is mainly a risk of reduced voxelotor efficacy.
How serious is the interaction between Bosentan and Voxelotor?
MediHelp rates it moderate, 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; if it is necessary, increase the voxelotor dose as directed in its labeling and monitor hemoglobin and clinical response. Monitor for bosentan adverse effects such as liver enzyme elevation and edema.
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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