Drug General Information (ID: DDI348V9PN)
Drug Name			Bosentan		Drug Info		Glyburide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Antidiabetic Agents
Structure

Mechanism of Bosentan-Glyburide Interaction (Severity Level: Major)
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Bosentan				Glyburide
Mechanism		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 1
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Bosentan and Glyburide

Recommended Action
Management		According to the manufacturer, the concomitant use of glyburide and bosentan is contraindicated. alternative hypoglycemic agents should be considered.

References
1	Product Information. Tracleer (bosentan). Acetelion Pharmaceuticals US, Inc, South San Francisco, CA.
2	Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72. [PMID: 6781341]
3	Van Giersbergen PL, Treiber A, Clozel M, Bodin F, Dingemanse J "In vivo and in vitro studies exploring the pharmacokinetic interaction between bosentan, a dual endothelin receptor antagonist, and glyburide." Clin Pharmacol Ther 71 (2002): 253-62.[PMID: 11956508]