Bosentan and PCE Dispertab

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using bosentan together with erythromycin may alter the blood levels of both medications. Specifically, the blood levels of erythromycin may decrease, which may reduce its effectiveness in treating your condition. At the same time, erythromycin may cause the blood levels of bosentan to increase. You may be more likely to experience side effects of bosentan such as nausea, vomiting, fatigue, headache, low blood pressure, fluid retention, anemia, and liver problems. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you develop fainting; sudden, unexplained weight gain; swelling of the legs or ankles; chest pain; or difficulty breathing during treatment with these medications. You should also seek medical attention if you experience potential signs and symptoms of liver damage such as fever, rash, loss of appetite, nausea, vomiting, fatigue, upper abdominal pain, dark urine, or yellowing of the skin and eyes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration of bosentan with a drug that is both a substrate as well as inhibitor of CYP450 2C9 and/or 3A4 may result in increased plasma concentrations of bosentan and decreased plasma concentrations of the other drug. Bosentan itself is a substrate and inducer of both CYP450 2C9 and 3A4. Theoretically, bosentan may induce metabolism of the coadministered drug while its own metabolism may be inhibited by the coadministered drug. According to the product labeling, administration of bosentan (125 mg orally twice a day) in combination with the potent CYP450 3A4 inhibitor ketoconazole resulted in approximately 2-fold increases in bosentan plasma concentrations. It is conceivable that concomitant administration of both a CYP450 2C9 inhibitor and a CYP450 3A4 inhibitor may lead to even larger increases in bosentan plasma concentrations.

MANAGEMENT: When a drug that is both a substrate as well as inhibitor of CYP450 2C9 and/or 3A4 is coadministered with bosentan, the possibility of diminished therapeutic response to the coadministered drug should be considered. Clinical and/or laboratory monitoring may be appropriate whenever bosentan is added to or withdrawn from therapy, and the dosage of the concomitant drug adjusted as necessary. The possibility of prolonged and/or increased pharmacologic effects of bosentan, including serious adverse effects such as hepatotoxicity, should also be considered. Patients should be advised to notify their physician if they experience signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, 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 combination CYP450 2C9/3A4 inhibitors (e.g., delavirdine, imatinib, miconazole, mifepristone, voriconazole) should probably be avoided also, if possible.

Bosentan

Generic Name: bosentan

Brand name: Tracleer

Synonyms: n.a.

What is Bosentan?

PCE Dispertab

Generic Name: erythromycin

Brand name: EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, E. E. S, EryPed, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV

Synonyms: PCE Dispertab (Oral), PCE, PCE (Oral)

What is PCE Dispertab?