Drug interactions
Isoniazid + Macitentan
Severity: Moderate
Isoniazid and Macitentan: 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
Macitentan is metabolized by CYP3A4 and exposure rises with strong inhibitors. Isoniazid is a much weaker inhibitor, so the increase is probably small. Both drugs can affect the liver, and macitentan can cause anemia and hypotension.
What this interaction means in plain words
Isoniazid and Macitentan 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.
Isoniazid belongs to Anti Bacterial; Macitentan belongs to Cardiovascular.
Why it happens
Weak CYP3A4 inhibition by isoniazid may raise macitentan levels, with overlapping hepatotoxicity.
What to do
Monitor liver enzymes, hemoglobin and blood pressure. Reassess therapy if transaminases rise.
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 Isoniazid
Other interactions of Macitentan
- Amiodarone + Macitentan Major
- Apalutamide + Macitentan Major
- Bosentan + Macitentan Major
- Carbamazepine + Macitentan Major
- Clarithromycin + Macitentan Major
- Efavirenz + Macitentan Major
Frequently asked questions
Can I take Isoniazid with Macitentan?
MediHelp rates the interaction as moderate. Isoniazid and Macitentan 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. Macitentan is metabolized by CYP3A4 and exposure rises with strong inhibitors. Isoniazid is a much weaker inhibitor, so the increase is probably small. Both drugs can affect the liver, and macitentan can cause anemia and hypotension.
How serious is the interaction between Isoniazid and Macitentan?
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 liver enzymes, hemoglobin and blood pressure. Reassess therapy if transaminases rise.
What other medicines interact with Isoniazid?
MediHelp also lists interactions of Isoniazid with, for example, Bacillus calmette-guerin substrain tice, Benzhydrocodone / acetaminophen, Carbamazepine. The full list is on the Isoniazid page.
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