Generic Name: bosentan (boe SEN tan)
Brand Name: Tracleer
Medically reviewed on November 20, 2017
What is bosentan?
Bosentan lowers blood pressure in your lungs, helping your heart pump blood more efficiently.
Bosentan is used to treat pulmonary arterial hypertension (PAH) in adults and children who are at least 3 years old. It improves your ability to exercise and prevents your condition from getting worse.
Bosentan is available only under a special program from a certified pharmacy. You must be registered in the program and understand the risks and benefits of taking this medication.
Bosentan may also be used for purposes not listed in this medication guide.
Do not use bosentan if you are pregnant or think you might be pregnant. You will need to take a pregnancy test before, during, and after treatment with bosentan. Use highly effective birth control to prevent pregnancy while using bosentan and for at least 30 days after your last dose.
Certain other medicines can interact with bosentan and should not be used at the same time. Tell your doctor about all your current medicines.
Bosentan can cause severe liver problems. Your liver function will need to be tested often.
Bosentan is available only from a certified pharmacy under a special program.
Before taking this medicine
You should not use bosentan if you are allergic to it, or if you are pregnant or might become pregnant during treatment.
Some medicines can interact with bosentan and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:
To make sure bosentan is safe for you, tell your doctor if you have:
if you have had or will have a heart or kidney transplant.
Do not use bosentan if you are pregnant or think you might be pregnant. This medicine can cause serious birth defects. Tell your doctor right away if you miss a menstrual period or think you may have become pregnant during treatment.
You will need to have a negative pregnancy test before starting this treatment. You will be re-tested every month during your treatment, and 1 month after you stop taking this medicine.
Even if you are not planning a pregnancy, you are considered able to become pregnant if:
you have entered puberty (even if you have not yet started having periods);
you have never had a hysterectomy or had your ovaries removed; or
you have not gone through menopause (you have never gone 12 months in a row without a menstrual period).
While taking bosentan and for at least 30 days after your last dose, you must use a highly effective form of birth control or two methods together.
A tubal ligation alone is an effective birth control method.
An intrauterine device (IUD) alone is also an effective birth control method.
If you use birth control pills, implants, injections, skin patches, or vaginal rings, you must use a back-up barrier form of birth control, such as a condom or diaphragm or cervical cap. Always use a spermicide gel or insert together with a barrier form of birth control.
If your sexual partner has had a vasectomy, you must still use a second method of birth control--either a barrier method or a hormonal form (birth control pills, injections, skin patch, or vaginal ring).
Bosentan comes with patient instructions about acceptable forms of birth control to use while taking this medicine. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
If you are the parent or caregiver of a female child taking this medicine, talk to the child's doctor once you notice any signs of puberty (breast development or pubic hair), even if menstrual periods have not yet begun.
Bosentan can decrease sperm count and may affect fertility in men (your ability to have children).
It is not known whether bosentan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
How should I take bosentan?
Bosentan is usually taken 2 times per day. Your doctor may change your dose after 4 weeks of treatment. Follow all directions on your prescription label. Do not take bosentan in larger or smaller amounts or for longer than recommended.
You may take bosentan with or without food.
Do not swallow a dispersible tablet whole. Place it into a small amount of water and allow the tablet to disperse in the liquid. The tablet will not dissolve completely. Stir gently and drink this mixture right away.
If your doctor tells you to use only half of a dispersible tablet, break the tablet at the line scored on it and disperse only one tablet half in water. Place the unused tablet half back into the blister pack for storage, and use that half within 7 days. Do not break a tablet half into smaller pieces.
Bosentan can cause severe liver problems. Your liver function will need to be tested before you start taking bosentan, and again each month during your treatment.
Your blood cells may also need to be tested during treatment and for up to 3 months after you stop taking this medicine.
You should not stop using bosentan suddenly. Stopping suddenly may make your condition worse. Follow your doctor's instructions about tapering your dose.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while using bosentan?
Do not have unprotected sex if you are able to become pregnant.
Bosentan side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using bosentan.
Call your doctor at once if you have:
swelling in your legs or ankles, with or without weight gain;
pale skin, feeling short of breath, rapid or irregular heart rate, trouble concentrating;
a light-headed feeling, like you might pass out;
liver problems--nausea, vomiting, fever, upper stomach pain, tiredness, dark urine, jaundice (yellowing of the skin or eyes); or
new lung problems--anxiety, sweating, pale skin, severe shortness of breath, wheezing, gasping for breath, cough with foamy mucus, chest pain, fast or uneven heart rate.
Common side effects may include:
headache, joint pain;
low blood pressure, fainting;
flushing (warmth, redness, or tingly feeling);
irregular heartbeats; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Bosentan dosing information
Usual Adult Dose for Pulmonary Hypertension:
Initial dose: 62.5 mg orally twice a day for 4 weeks
Maintenance dose: Following initial dose, increase to 125 mg orally twice a day
-Doses above 125 mg twice a day did not appear to confer additional benefit sufficient enough to offset increased risk of hepatotoxicity.
Use: For the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability and to decrease clinical worsening.
Usual Pediatric Dose for Pulmonary Hypertension:
3 to 12 years:
4 kg to 8 kg: 16 mg orally twice a day
Greater than 8 kg to 16 kg: 32 mg orally twice a day
Greater than 16 kg to 24 kg: 48 mg orally twice a day
Greater than 24 kg to 40 kg: 64 mg orally twice a day
Greater than 12 years:
-Less than 40 kg: 62.5 mg orally twice a day
-Greater than 40 kg: 62.5 mg orally twice a day for 4 weeks, then increase to 125 mg orally twice a day
Use: For use in pediatric patients 3 years or older with idiopathic or congenital PAH to improve pulmonary vascular resistance, which is expected to result in an improvement in exercise ability
What other drugs will affect bosentan?
Tell your doctor about all your current medicines and any you start or stop using, especially:
hormonal forms of birth control--birth control pills, injections, skin patches, or implants; or
This list is not complete. Other drugs may interact with bosentan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2018 Cerner Multum, Inc. Version: 8.01.
More about bosentan
- Bosentan Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- Support Group
- En Español
- 5 Reviews
- Drug class: agents for pulmonary hypertension
Other brands: Tracleer