Drug Interaction Report

Bosentan and Leniolisib: Interaction Details

A pharmacist-reviewed analysis of the Bosentan and Leniolisib interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Bosentan

No brand names on record
+

Leniolisib

Joenja Joenja®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 67 documented Bosentan interactions, 53 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Increased bosentan exposure, reduced leniolisib exposure and reduced efficacy of leniolisib

Interaction Deep Dive

Avoid concomitant use of leniolisib with bosentan (a moderate CYP3A4 inducer and a OATP1B1 substrate). Concomitant use of leniolisib with moderate CYP3A4 inducers may result in reduced leniolisib exposure and thus reduced leniolisib efficacy. Concomitant administration of leniolisib with a OATP1B1 substrate may possibly increase the systemic exposure of this substrate1.

Why it happens (mechanism)

Inhibition of OATP1B1-mediated efflux transport by leniolisib; induction of CYP3A4-mediated metabolism of leniolisib

Literature reports

2 reports — tap to read

a) Physiologically-based pharmacokinetic (PBPK) model-based simulations predicted a maximum decrease of 58% in leniolisib AUC(0-12) with efavirenz (a moderate CYP3A4 inducer) 1.

b) Leniolisib was identified in vitro as a potential inhibitor of the hepatic uptake and efflux transporters OATP1B1 1.

Common questions

Can I take Bosentan and Leniolisib together?

Increased bosentan exposure, reduced leniolisib exposure and reduced efficacy of leniolisib Always confirm with your pharmacist or prescriber before making any change.

How serious is the Bosentan and Leniolisib interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Bosentan or Leniolisib 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 a safer alternative to one of these medications for me?

References (1)

  1. Product Information: JOENJA(R) oral tablets, leniolisib oral tablets. Pharming Healthcare, Inc (per FDA), Bridgewater, NJ, 2023. DailyMed
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Bosentan

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Leniolisib

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Beyond drug–drug

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:

Bosentan + Activated Charcoal American Hellebore American Mistletoe Apple Beer Grapefruit Siberian Cocklebur St. John's Wort + 258 more
Leniolisib + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 137 more

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.