Drug interactions
Bosentan + Voxilaprevir
Severity: Major
Bosentan and Voxilaprevir: 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 may reduce voxilaprevir concentrations through CYP3A4 induction, and voxilaprevir may also be affected through transporter effects. Lower antiviral exposure could reduce the likelihood of sustained virologic response in hepatitis C treatment.
What this interaction means in plain words
Bosentan and Voxilaprevir 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; Voxilaprevir belongs to Anti Virals.
Why it happens
Bosentan induces CYP3A4 (and possibly transporters such as P-gp), increasing voxilaprevir metabolism and lowering plasma levels.
What to do
Avoid coadministration; consider an alternative endothelin receptor antagonist or defer therapy if clinically acceptable. If unavoidable, monitor HCV RNA response 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?
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Other interactions of Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Cyclosporine Contraindicated
- Bosentan + Glyburide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
Other interactions of Voxilaprevir
- Apalutamide + Voxilaprevir Contraindicated
- Phenytoin + Voxilaprevir Contraindicated
- Carbamazepine + Voxilaprevir Major
- Efavirenz + Voxilaprevir Major
- Enzalutamide + Voxilaprevir Major
- Lorlatinib + Voxilaprevir Major
Frequently asked questions
Can I take Bosentan with Voxilaprevir?
MediHelp rates the interaction as major. Bosentan and Voxilaprevir 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 may reduce voxilaprevir concentrations through CYP3A4 induction, and voxilaprevir may also be affected through transporter effects. Lower antiviral exposure could reduce the likelihood of sustained virologic response in hepatitis C treatment.
How serious is the interaction between Bosentan and Voxilaprevir?
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 coadministration; consider an alternative endothelin receptor antagonist or defer therapy if clinically acceptable. If unavoidable, monitor HCV RNA response closely.
What other medicines interact with Bosentan?
MediHelp also lists interactions of Bosentan with, for example, Cyclosporin, Cyclosporine, Glyburide. The full list is on the Bosentan page.
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