Лекарственные взаимодействия
Bosentan + Cyclosporine
Тяжесть: Противопоказано
Bosentan and Cyclosporine: contraindicated interaction.
Последнее обновление Источники: US FDA label
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Кратко
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.
Что означает это взаимодействие простыми словами
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.
Почему это происходит
Cyclosporine inhibits OATP-mediated hepatic uptake and CYP3A4 metabolism of bosentan, while bosentan induces CYP3A4, accelerating cyclosporine metabolism.
Что делать
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.
О чём спросить фармацевта
- 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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Источники
Другие взаимодействия Bosentan
- Bosentan + Cyclosporin Противопоказано
- Bosentan + Glyburide Противопоказано
- Bosentan + Glyburide-metformin Противопоказано
- Bosentan + Lonafarnib Противопоказано
- Bosentan + Sparsentan Противопоказано
- Artemether / lumefantrine + Bosentan Тяжёлое
Частые вопросы
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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