Generic
Bosentan
Brand Name
Tracleer
Import ID
118
Bosentan
| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Ritonavir Bosentan 1037 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of bosentan | Possible increased bosentan effects |
Not studied |
Not studied (may increase bosentan levels) |
Start low and titrate bosentan to effect. If patient has been on protease inhibitor (other than unboosted atazanavir) for more than 10 days, start bosentan at 62.5 mg daily or every other day. If patient is currently on bosentan and requires a PI (other than unboosted atazanavir), stop bosentan for at least 36 hours prior to initiating ART. Wait 10 days and then resume bosentan starting with 62.5 mg daily or every other day. |
|
| Darunavir Bosentan 878 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of bosentan | Potential for increased risk of bosentan adverse effects |
Start low and titrate bosentan to effect. If patient has been on protease inhibitor (other than unboosted atazanavir) for more than 10 days, start bosentan at 62.5 mg daily or every other day. If patient is currently on bosentan and requires a PI (other than unboosted atazanavir), stop bosentan for at least 36 hours prior to initiating ART. Wait 10 days and then resume bosentan starting with 62.5 mg daily or every other day. |
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| Atazanavir Bosentan 773 | Yellow: Adjust dosing | Adjust dosing to avoid reduced atazanavir levels | Potential decreased antiviral effects of atazanavir |
Do not coadminister bosentan with unboosted atazanavir, For patients receiving atazanavir plus ritonavir for >10 days, start bosentan at 62.5mg daily or every other day based on individual tolerability, Discontinue bosentan at least 36 hours before starting atazanavir / ritonavir. At least 10 days after starting atazanavir / ritonavir, resume bosentan at 62.5mg daily or every other day based on individual tolerability. |
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| Nevirapine Bosentan 633 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential decreased etravirine effects; potential decreased bosentran effects |
If coadministring, monitor bosentran efficacy and virologic response |
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| Etravirine Bosentan 560 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential decreased etravirine effects; potential decreased bosentran effects |
If coadministring, monitor bosentran efficacy and virologic response |
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| Efavirenz Bosentan 495 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential decreased Efavirenz effects; potential decreased bosentran effects |
If coadministring, monitor bosentran efficacy and virologic response |
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| Elvitegravir Bosentan 154 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of bosentan | Potential for increased risk of bosentan adverse effects |
If patient has been on elvitegravir / cobicistat for more than 10 days, start with bosentan dose of 62.5 mg daily or every other day. If patient is currently on bosentan and requires use of elvitegravir / cobicistat, stop bosentan for at least 36 hours prior to initiating ART. Wait 10 days and then resume bosentan starting with 62.5 mg daily or every other day. |
