Macitentan interactions
Full monograph for MacitentanCheck it against another medicine
Medicines
102 documented
Mechanism
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Apalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Carbamazepine | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Ceritinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Enzalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| ErythromycinLotionOral | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Fosphenytoin Sodium | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Itraconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Ketoconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Ketoconazole + Zinc Pyrithione + Aleovera | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Leflunomide | Major | Synergy | The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity may… | 3 sources — open the full entry |
| Lopinavir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Nelfinavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Nirmatrelvir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Phenobarbital | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Phenytoin Sodium | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Posaconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Primidone | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Rabeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Rifampicin | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Rifampicin + Isoniazid | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the…2 documented mechanisms | 4 sources — open the full entry |
| Rifampicin + Isoniazid + Pyrazinamide + Ethambutol | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of macitentan, which is primarily metabolized by the…2 documented mechanisms | 4 sources — open the full entry |
| Tucatinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Vonoprazan + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Voriconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of macitentan, which is primarily metabolized by the… | 3 sources — open the full entry |
| Abametapir | Moderate | Metabolism | Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450… | 1 sources — open the full entry |
| Amiodarone Hydrochloride | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Aprepitant | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Asciminib | Moderate | Metabolism | Coadministration with asciminib may increase the plasma concentrations of drugs that are primarily metabolized by the CYP450 3A4 isoenzyme. The mechanism is… | 1 sources — open the full entry |
| Beclomethasone Dipropionate + Chloramphenicol + Clotrimazole + Lidocaine | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme.2 documented mechanisms | 1 sources — open the full entry |
| Betamethasone + Clotrimazole | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Betamethasone + Clotrimazole + Gentamicin | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Bosentan Monohydrate | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 2 sources — open the full entry |
| Calcium Dobesilate + Lidocaine + Dexamethasone | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 2 sources — open the full entry |
| Cenobamate | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 2 sources — open the full entry |
| Chloramphenicol (Oral) | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Chloramphenicol + Lidocaine Hydrochloride | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| CiprofloxacinbaseOphthalmic | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Ciprofloxacin + Dexamethasone | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme.2 documented mechanisms | 3 sources — open the full entry |
| Ciprofloxacin + Hydrocortisone Acetate | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| ClotrimazoleEar dropEye ointmentTopicalVaginal tablet | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Clotrimazole + Hydrocortisone | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Copper Peptide + Procapil + Niacinamide + Biotin + L-Arginine | Moderate | Synergy | Coadministration of L-arginine or L-citrulline may potentiate the hypotensive effects of nitrates and vasodilators. Both L-arginine and L-citrulline are amino… | 1 sources — open the full entry |
| Crizotinib | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Danazol | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Dasatinib | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 1 sources — open the full entry |
| Deferasirox | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 2 sources — open the full entry |
| Dexamethasone | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of macitentan, which is primarily metabolized by the isoenzyme. | 2 sources — open the full entry |
Conditions
Conditions in which Macitentan needs care, as documented in this source.
Liver Failure
MajorEndothelin 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.
4 sources
- "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
- "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
- "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
- "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc. (2023):
Anemia
ModerateClinical 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.
3 sources
- "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
- "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
- "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
Water-Electrolyte Imbalance
ModeratePeripheral 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.
4 sources
- "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
- "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
- "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
- "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc. (2023):