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Interações medicamentosas

Bosentan + Cyclosporine

Gravidade: Contraindicada

Bosentan and Cyclosporine: contraindicated interaction.

Última atualização Fontes: US FDA label

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Resumo

Cyclosporine markedly increases bosentan plasma concentrations, while bosentan lowers cyclosporine levels. The rise in bosentan raises the risk of hepatotoxicity, and reduced cyclosporine can compromise immunosuppression and risk graft rejection. Labeling advises against concomitant use.

O que esta interação significa em palavras simples

Bosentan and Cyclosporine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Nível de evidência: High

Por que acontece

Cyclosporine inhibits OATP-mediated hepatic uptake and CYP3A4 metabolism of bosentan, while bosentan induces CYP3A4, accelerating cyclosporine metabolism.

O que fazer

Do not co-administer; select an alternative pulmonary hypertension therapy, such as a PDE5 inhibitor, if cyclosporine is required. If bosentan is already in use, discuss alternatives with the transplant and pulmonary hypertension teams before starting cyclosporine.

O que perguntar ao farmacêutico

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

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Referências

Perguntas frequentes

Can I take Bosentan with Cyclosporine?

MediHelp rates the interaction as contraindicated. Bosentan and Cyclosporine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Cyclosporine markedly increases bosentan plasma concentrations, while bosentan lowers cyclosporine levels. The rise in bosentan raises the risk of hepatotoxicity, and reduced cyclosporine can compromise immunosuppression and risk graft rejection. Labeling advises against concomitant use.

How serious is the interaction between Bosentan and Cyclosporine?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; select an alternative pulmonary hypertension therapy, such as a PDE5 inhibitor, if cyclosporine is required. If bosentan is already in use, discuss alternatives with the transplant and pulmonary hypertension teams before starting cyclosporine.

What other medicines interact with Bosentan?

MediHelp also lists interactions of Bosentan with, for example, Cyclosporin, Glyburide, Glyburide-metformin. The full list is on the Bosentan page.

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