What we need to know about drug interactions in patients with pulmonary arterial hypertension

Wustmann, Kerstin; Schmidheiny, Pascal; Schwerzmann, Markus

doi:10.1016/j.ppedcard.2012.08.011

Progress in Pediatric Cardiology

2012

DOI: 10.1016/j.ppedcard.2012.08.011

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What we need to know about drug interactions in patients with pulmonary arterial hypertension

Kerstin Wustmann

Pascal Schmidheiny

Markus Schwerzmann

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Bosentan/rifampicin interaction

2013

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A 48-year-old man experienced shortness of breath and increased pulmonary arterial pressure caused by an interaction between rifampicin and bosentan.The man had tetralogy of Fallot and a history of multiple major aorto-pulmonary collaterals, and he had undergone pulmonary valve replacement by a homograft. He was receiving bosentan [dosage, route and duration of therapy not stated] for pulmonary arterial hypertension, as well as a number of concomitant drugs, when he started receiving rifampicin [dosage and route not stated] and ciprofloxacin for a Staphylococcus aureus infection and suspected endocarditis of the pulmonary homograft. Two weeks later, although his infection had resolved, he developed increasing shortness of breath, and increased N-terminal prohormone brain natriuretic peptide levels, with increased pulmonary arterial pressures [outcome not stated].Author comment: "In fact, the antibiotic treatment with rifampicin, although effective for the bacterial infection, had a deleterious effect on pulmonary vasodilatory treatment with bosentan. Rifampicin as an inducer of the cytochrome P450 3A4 (CYP3A4) caused an accelerated metabolism of the ERA and reduced its plasma levels."

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Bosentan/rifampicin interaction

2013

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What we need to know about drug interactions in patients with pulmonary arterial hypertension

Cited by 1 publication

References 26 publications

Bosentan/rifampicin interaction

Bosentan/rifampicin interaction

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