Drug interactions
Bosentan + Warfarin
Severity: Moderate
Bosentan and Warfarin: 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 an enzyme inducer and can reduce warfarin exposure, lowering INR. Loss of anticoagulation may result without dose adjustment.
What this interaction means in plain words
Bosentan and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Induction of CYP2C9 and CYP3A4 by bosentan increases warfarin metabolism.
What to do
Monitor INR closely when bosentan is started, changed or stopped, and increase the warfarin dose as required. Recheck INR within the first weeks of therapy.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin 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 Warfarin?
MediHelp rates the interaction as moderate. Bosentan and Warfarin 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 an enzyme inducer and can reduce warfarin exposure, lowering INR. Loss of anticoagulation may result without dose adjustment.
How serious is the interaction between Bosentan and Warfarin?
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 INR closely when bosentan is started, changed or stopped, and increase the warfarin dose as required. Recheck INR within the first weeks of therapy.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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