Macitentan interactions

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Medicines

102 documented

Severity

Mechanism

Medicines documented to interact with Macitentan, worst severity first.
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
ErythromycinLotion Oral	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
Ciprofloxacinbase Ophthalmic	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 drop Eye ointment Topical Vaginal 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
Major
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.
4 sources
1. "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
2. "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
3. "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
4. "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc. (2023):
Anemia
Moderate
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.
3 sources
1. "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
2. "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
3. "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
Water-Electrolyte Imbalance
Moderate
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.
4 sources
1. "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc (2001):
2. "Product Information. Letairis (ambrisentan)." Gilead Sciences (2007):
3. "Product Information. Opsumit (macitentan)." Actelion Pharmaceuticals US Inc (2013):
4. "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc. (2023):

Medicines

Conditions

Liver Failure

Anemia

Water-Electrolyte Imbalance