Bosentan (Tracleer)

Indications

Pulmonary Hypertension (see Pulmonary Hypertension, [[Pulmonary Hypertension]])

  • Congenital Heart Disease with L->R Shunt-Associated Pulmonary Hypertension
  • Connective Tissue Disease-Associated Pulmonary Hypertension
  • Idiopathic Pulmonary Arterial Hypertension (IPAH) (see Idiopathic Pulmonary Arterial Hypertension, [[Idiopathic Pulmonary Arterial Hypertension]])

Contraindications

  • Pregnancy: teratogenic

Pharmacology

Metabolism

  • xxx

Administration

  • PO: xxx

Dose Adjustment

  • Hepatic
  • Renal

Drug Interactions

  • Cyclosporine A: coadministration of cyclosporine A and bosentan markedly increases plasma bosentan concentration
  • Glyburide: coadministration of glyburide and bosentan may result in increased liver function tests

Adverse Effects

Cardiovascular Adverse Effects

  • Fluid Retention/Peripheral Edema (see Peripheral Edema, [[Peripheral Edema]])
    • Known effect of endothelin receptor antagonists
    • May occur within the first few weeks of starting bosentan
  • Hypotension (see Hypotension, [[Hypotension]])

Dermatologic Adverse Effects

  • Rash

Gastroenterologic Adverse Effects

Hematologic Adverse Effects

  • Anemia (see Anemia, [[Anemia]])

Immunologic Adverse Effects

Pulmonary Adverse Effects

  • Pulmonary Edema: may occur in patients with pulmonary veno-occlusive disease (VOD), suggesting this as an alternate diagnosis (see Pulmonary Veno-Occlusive Disease, [[Pulmonary Veno-Occlusive Disease]])

Other Adverse Effects

  • xxx

References

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