Puravive - Tracleer (Bosentan) Interaction

Interaction Details

Bosentan is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Interaction Details

Bosentan is classified as belonging to the following category: Antihypertensive Drugs

Puravive contains quercetin, which has been found to slightly reduce blood pressure in individuals with mild hypertension (https://pubmed.ncbi.nlm.nih.gov/17951477/). There is a theoretical possibility that it could enhance the blood pressure-lowering effects of antihypertensive medications.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Interaction Details

Bosentan is classified as belonging to the following category: Cytochrome P450 2C9 (Cyp2C9) Substrates

Puravive contains quercetin, which has been shown in studies to mildly inhibit the CYP2C9 metabolizing enzyme. This inhibition could potentially increase the risk of side effects from drugs. A small clinical trial with healthy volunteers found that taking 500 mg of quercetin twice daily for 10 days before using diclofenac, a drug metabolized by CYP2C9, increased diclofenac plasma levels by 75% and extended its half-life by 32.5% (source: https://pubmed.ncbi.nlm.nih.gov/29168292/). Combining quercetin with drugs metabolized by CYP2C9 could increase the risk of side effects, so caution is advised.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Interaction Details

Bosentan is classified as belonging to the following category: Organic Anion-Transporting Polypeptide Substrates (Oatp)

Puravive contains quercetin. The simultaneous use of quercetin and OATP substrates (the drug in question in this interaction is reported to be an OATP substrate) may theoretically enhance their effects and adverse effects. In vitro studies indicate that quercetin can inhibit the uptake of estrone-3-sulfate and pravastatin, which are transported by OATP 1B1. Clinical research in healthy males demonstrates that co-administration of quercetin and pravastatin increases the area under the curve (AUC) of pravastatin by 24%, prolongs its half-life by 14%, and reduces its apparent clearance by 18% (source: https://pubmed.ncbi.nlm.nih.gov/22114872/). Overall, quercetin may increase the risk of side effects of drugs that are OATP substrates when taken together.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Bosentan Overview

• Bosentan is used to treat pulmonary arterial hypertension (PAH, high blood pressure in the vessels that carry blood to the lungs) in adults and children 3 years of age and older. Bosentan may improve the ability to exercise and slow the worsening of symptoms in patients with PAH. Bosentan is in a class of medications called endothelin receptor antagonists. It works by stopping the action of endothelin, a natural substance that causes blood vessels to narrow and prevents normal blood flow in people who have PAH.

Puravive - More Interactions

Puravive interacts with 1207 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.