Interactions between Bosentan and Danazol
1 drug interaction and 19 additional warnings found for the following 2 drugs:
- bosentan
- danazol
Drug interactions
Moderate drug interactions
Moderate:
danazol bosentan
Applies to: danazol and bosentan
Monitor
Coadministration with inhibitors of CYP450 2C9 and/or 3A4 may increase the plasma concentrations of bosentan, which is metabolized by these isoenzymes. When bosentan 125 mg orally twice a day was administered with the potent CYP450 3A4 inhibitor ketoconazole, bosentan plasma concentrations increased by approximately 2-fold. Concomitant administration of both a CYP450 2C9 inhibitor and a CYP450 3A4 inhibitor may lead to even larger increases in plasma concentrations of bosentan.
Management
The possibility of prolonged and/or increased pharmacologic effects of bosentan, including serious adverse effects such as hepatotoxicity, should be considered during coadministration with CYP450 2C9 or 3A4 inhibitors. Patients should be advised to notify their physician if they experience signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice. Concomitant administration of bosentan with both a potent CYP450 2C9 inhibitor (e.g., fluconazole, amiodarone) and a potent CYP450 3A4 inhibitor (e.g., ketoconazole, itraconazole, ritonavir) is not recommended. Concomitant administration with dual inhibitors of CYP450 2C9 and 3A4 (e.g., asciminib, delavirdine, imatinib, miconazole, voriconazole) should probably be avoided also, if possible.
References (1)
- (2001) "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc
Food/lifestyle interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
19 potential interactions Applies to: 17 conditions, including High Blood Pressure, Migraine, Heart Failure, Seizures, and Anemia.
Abnormal Uterine Bleeding
Major:
danazol
Danazol has a major potential interaction with Abnormal Uterine Bleeding.
The use of danazol is contraindicated in patients with undiagnosed, abnormal genital bleeding. Patients should be evaluated to ensure that neoplastic lesions are not present. Alterations of menstruation including irregular cycles, amenorrhea, breakthrough bleeding, and spotting have occurred during danazol therapy.
Anemia
Moderate:
bosentan
Bosentan has a moderate potential interaction with Anemia.
Clinical studies have shown that most endothelin receptor antagonists decrease hemoglobin concentration and hematocrit levels. There are some postmarketing reports of anemia cases which needed blood transfusion. Hemoglobin and hematocrit levels should be measured prior to treatment initiation and should be monitored periodically thereafter. Initiation of therapy is not recommended in patients with clinically significant anemia.
Bleeding Disorder
Major:
danazol
Danazol has a major potential interaction with Bleeding Disorder.
Danazol is contraindicated in patients with thrombosis or thromboembolic disease or a history of such events. Thromboembolism, thrombotic and thrombophlebitic events, including fatal strokes, have occurred during danazol therapy. Hematuria, menstrual spotting and thrombocytopenia have also occurred. Additionally, therapy with danazol should be administered cautiously in patients with or predisposed to bleeding/clotting disorders.
Diabetes Mellitus
Major:
danazol
Danazol has a major potential interaction with Diabetes Mellitus.
Danazol possess androgenic activity that can result in salt and water retention. Danazol is eliminated by the kidney, and its use is contraindicated in patients with severe renal dysfunction. It should also be administered cautiously in patients adversely affected by volume overload, such as patients suffering from epilepsy, diabetes mellitus, migraine, cardiac or renal dysfunction, polycythemia and hypertension. These patients will require careful observation.
Fluid Retention
Major:
danazol
Danazol has a major potential interaction with Fluid Retention.
Danazol possess androgenic activity that can result in salt and water retention. Danazol is eliminated by the kidney, and its use is contraindicated in patients with severe renal dysfunction. It should also be administered cautiously in patients adversely affected by volume overload, such as patients suffering from epilepsy, diabetes mellitus, migraine, cardiac or renal dysfunction, polycythemia and hypertension. These patients will require careful observation.
Heart Disease
Major:
danazol
Danazol has a major potential interaction with Heart Disease.
Danazol is contraindicated in patients with marked impaired cardiac function.
Heart Failure
Major:
danazol
Danazol has a major potential interaction with Heart Failure.
Danazol possess androgenic activity that can result in salt and water retention. Danazol is eliminated by the kidney, and its use is contraindicated in patients with severe renal dysfunction. It should also be administered cautiously in patients adversely affected by volume overload, such as patients suffering from epilepsy, diabetes mellitus, migraine, cardiac or renal dysfunction, polycythemia and hypertension. These patients will require careful observation.
Moderate:
bosentan
Bosentan has a moderate potential interaction with Heart Failure.
Peripheral edema and fluid retention are known clinical consequences of pulmonary hypertension and also known effects of endothelin receptor antagonists. Caution and monitoring is recommended if these agents are used in patients with underlying left ventricular dysfunction or underlying heart failure, as they have an increased risk for developing significant fluid retention that may need treatment or require discontinuation.
High Blood Pressure
Major:
danazol
Danazol has a major potential interaction with High Blood Pressure.
Danazol possess androgenic activity that can result in salt and water retention. Danazol is eliminated by the kidney, and its use is contraindicated in patients with severe renal dysfunction. It should also be administered cautiously in patients adversely affected by volume overload, such as patients suffering from epilepsy, diabetes mellitus, migraine, cardiac or renal dysfunction, polycythemia and hypertension. These patients will require careful observation.
History, Thrombotic/Thromboembolic Disorder
Major:
danazol
Danazol has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.
Danazol is contraindicated in patients with thrombosis or thromboembolic disease or a history of such events. Thromboembolism, thrombotic and thrombophlebitic events, including fatal strokes, have occurred during danazol therapy. Hematuria, menstrual spotting and thrombocytopenia have also occurred. Additionally, therapy with danazol should be administered cautiously in patients with or predisposed to bleeding/clotting disorders.
Liver Disease
Major:
bosentan
Bosentan has a major potential interaction with Liver Disease.
Endothelin receptor antagonists (ERAs) have been associated with aminotransferase elevations, hepatotoxicity, and cases of liver failure. Hepatic function should be assessed before treatment initiation and closely monitored during treatment. Therapy should be discontinued if aminotransferase elevations are accompanied by increases in bilirubin, or clinical symptoms of hepatotoxicity such as nausea, vomiting, fever, abdominal pain or jaundice. Treatment should be avoided in patients with elevated aminotransferases at baseline as monitoring for hepatotoxicity may be more difficult. In general, the use of ERAs is not recommended for patients with moderate to severe hepatic impairment.
Major:
danazol
Danazol has a major potential interaction with Liver Disease.
The use of danazol is contraindicated in patients with severe hepatic impairment. Danazol is metabolized by the liver to inactive forms. Metabolic and therapeutic activity of danazol may be altered in patients with severe hepatic dysfunction. Elevated serum transaminase levels, peliosis hepatis and benign hepatic adenoma have occurred during chronic administration of danazol. Therapy with danazol should be administered cautiously in patients with or predisposed to hepatic dysfunction.
Migraine
Major:
danazol
Danazol has a major potential interaction with Migraine.
Danazol possess androgenic activity that can result in salt and water retention. Danazol is eliminated by the kidney, and its use is contraindicated in patients with severe renal dysfunction. It should also be administered cautiously in patients adversely affected by volume overload, such as patients suffering from epilepsy, diabetes mellitus, migraine, cardiac or renal dysfunction, polycythemia and hypertension. These patients will require careful observation.
Porphyria
Major:
danazol
Danazol has a major potential interaction with Porphyria.
The use of danazol is contraindicated in patients with porphyria. Danazol can induce production of delta- aminolevulinic acid (ALA) synthetase activity resulting in porphyrin metabolism.
Prostate Tumor, Benign
Major:
danazol
Danazol has a major potential interaction with Prostate Tumor, Benign.
The use of danazol is contraindicated in patients with androgen- dependent tumors.
Pseudotumor Cerebri
Major:
danazol
Danazol has a major potential interaction with Pseudotumor Cerebri.
Intracranial hypertension (pseudotumor cerebri) has occurred in patients receiving danazol. Therapy with danazol should be administered cautiously in patients with or predisposed to cerebral or papilledema and/or intracranial hypertension.
Renal Dysfunction
Major:
danazol
Danazol has a major potential interaction with Renal Dysfunction.
Danazol possess androgenic activity that can result in salt and water retention. Danazol is eliminated by the kidney, and its use is contraindicated in patients with severe renal dysfunction. It should also be administered cautiously in patients adversely affected by volume overload, such as patients suffering from epilepsy, diabetes mellitus, migraine, cardiac or renal dysfunction, polycythemia and hypertension. These patients will require careful observation.
Seizures
Major:
danazol
Danazol has a major potential interaction with Seizures.
Danazol possess androgenic activity that can result in salt and water retention. Danazol is eliminated by the kidney, and its use is contraindicated in patients with severe renal dysfunction. It should also be administered cautiously in patients adversely affected by volume overload, such as patients suffering from epilepsy, diabetes mellitus, migraine, cardiac or renal dysfunction, polycythemia and hypertension. These patients will require careful observation.
Thrombotic/Thromboembolic Disorder
Major:
danazol
Danazol has a major potential interaction with Thrombotic/Thromboembolic Disorder.
Danazol is contraindicated in patients with thrombosis or thromboembolic disease or a history of such events. Thromboembolism, thrombotic and thrombophlebitic events, including fatal strokes, have occurred during danazol therapy. Hematuria, menstrual spotting and thrombocytopenia have also occurred. Additionally, therapy with danazol should be administered cautiously in patients with or predisposed to bleeding/clotting disorders.
More resources
bosentan
A total of 528 drugs are known to interact with bosentan.
- Bosentan is in the drug class agents for pulmonary hypertension.
- Bosentan is used to treat Pulmonary Arterial Hypertension.
danazol
A total of 270 drugs are known to interact with danazol.
- Danazol is in the drug class antigonadotropic agents.
- Danazol is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.