Silkay Drug Interactions

Metabolism/Transport effects: Substrate of CYP2C9 (minor), CYP3A4 (minor), SLCO1B1.
Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential; induces CYP2C9 (weak/moderate), CYP3A4 (moderate).
Avoid Concomitant Use: Avoid concomitant use of Bosentan with any of the following: Antihepaciviral Combination Products; Asunaprevir; Axitinib; Bedaquiline; Bosutinib; Cobimetinib; Cyclosporine (systemic); Dasabuvir; Deflazacort; Elbasvir; Flibanserin; Glyburide; Grazoprevir; Nisoldipine; Olaparib; Ranolazine; Simeprevir; Sonidegib; Ulipristal; Velpatasvir; Venetoclax.
Increased Effect/Toxicity: Bosentan may increase the levels/effects of: Clarithromycin; ifosfamide.
The levels/effects of Bosentan may be increased by: Atazanavir; Boceprevir; Clarithromycin; Cobicistat; Cyclosporine (systemic); CYP2C9 Inhibitors (moderate); CYP2C9 inhibitors (strong); CYP3A4 inhibitors (moderate); CYP3A4 inhibitors (strong); Darunavir; Eltrombopag; Fosamprenavir; Gemfibrozil; Glyburide; Indinavir; Lopinavir; Nelfinavir; Phosphodiesterase 5 inhibitors; Rifampin; Ritonavir; Saquinavir; Telaprevir; Teriflunomide; Tipranavir.
Decreased Effect: Bosentan may decrease the levels/effects of: Antihepaciviral Combination Products: Asunaprevir; Atazanavir; Axitinib; Bedaquiline; Boceprevir; Bosutinib; Clarithromycin; Clozapine; Cobimetinib; Contraceptives (estrogens); Contraceptives (progestins); Cyclosporine (systemic); CYP3A4 Substrates; Daclatasvir; Darunavir; Dasabuvir; Deflazacort; Elbasvir; Estriol (systemic); Estriol (topical); Fentanyl; Filbanserin; Fosamprenavir; Glyburide; Grazoprevir; Guanfacine; Hydrocodone; Ibrutinib; Ifosfamide; Indinavir; Lopinavir; Lurasidone; Mirodefanil; Nelfinavir; Nimodipine; Nisoldipine; Olaparib; Palbociclib; Phosphodiesterase 5 inhibitors; Ranolazine; Rolapitant; Saquinavir; Saxagliptin; Simeprevir; Simvastatin; Sonidegib; Telaprevir; Tipranavir; Ulipristal; Velpatasvir; Venetoclax; Vitamin K antagonist; Zolpidem.
The levels/effect of Bosentan may be decreased by: Glyburide, rifampicin.
Food interactions: Bioavailability of bosentan is not affected by food. Bosentan serum concentrations may be increased by grapefruit juice. Management: Avoid grapefruit/grapefruit juice.