Atorvastatin and Bosentan: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Bosentan
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced plasma concentrations and reduced efficacy of atorvastatin
Interaction Deep Dive
The plasma concentrations of simvastatin and its active beta-hydroxy acid metabolite were decreased by approximately 50% with coadministration of bosentan therapy. Bosentan plasma concentrations were unaffected. Bosentan is also expected to reduce plasma concentrations of other statins that have significant metabolism by cytochrome P450 3A4, such as atorvastatin. The possibility of reduced atorvastatin efficacy should be considered1.
Why it happens (mechanism)
Induction of cytochrome P4503A4-mediated metabolism of atorvastatin
Common questions
Can I take Atorvastatin and Bosentan together?
Reduced plasma concentrations and reduced efficacy of atorvastatin Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atorvastatin and Bosentan interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Atorvastatin or Bosentan need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: Tracleer(TM), bosentan. Actelion Pharmaceuticals US, Inc. South San Francisco, CA, 2001. DailyMed
Keep reading about Atorvastatin
Keep reading about Bosentan
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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