The usual dose is one tablet twice daily, morning and evening. You can take bosentan before or after food.
The most common side-effects are headache, and swollen feet and ankles.
Women who could get pregnant must use suitable contraception. You must discuss this with your doctor before you take bosentan.
|Type of medicine||Vasodilator antihypertensive medicine - an endothelin receptor antagonist|
|Used for||Pulmonary arterial hypertension, and to prevent digital ulcers in people with systemic sclerosis|
Pulmonary arterial hypertension (PAH) is a condition where there is too high a blood pressure in the blood vessels that supply your lungs from your heart. Bosentan relaxes the muscle cells in the walls of the blood vessels to your lungs, allowing them to become wider (dilated). This reduces the pressure in these blood vessels and allows blood to flow more easily through them. In turn, this increases the supply of blood to your lungs and improves your ability to do physical activities.
Bosentan is also prescribed for people with an autoimmune connective system disorder called systemic sclerosis. This is a disorder where your immune system (which normally protects your body) causes damage to your connective system. Some people with systemic sclerosis develop ulcers on their fingertips as a symptom of this condition. These ulcers can be painful and difficult to heal. Bosentan can help prevent new ulcers from occurring.
Bosentan will be prescribed for you by a doctor who is a specialist.
Before taking bosentan
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking bosentan tablets it is important that your doctor knows:
- If you are or could become pregnant, or if you are breast-feeding.
- If you have problems with the way your liver works.
- If you have a low blood pressure.
- If you have a rare inherited blood disorder called porphyria.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take bosentan tablets
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer’s leaflet will give you more information about bosentan and a full list of side-effects which you may experience from taking it.
- Take bosentan tablets exactly as your doctor tells you to. They are usually taken twice daily, morning and evening. There are two different strengths of tablet - 62.5 mg and 125 mg. It is likely you will be started on the lower strength and then changed to the higher strength after about four weeks. If bosentan has been prescribed for a child, the dose will be calculated from your child's weight and so will be different to the doses given here.
- Swallow the tablets whole with a drink of water - do not break or chew the tablets. You can take bosentan tablets before or after meals.
- If you forget to take a dose, take it as soon as you remember unless your next dose is due. If when you remember, your next dose is due, then take the dose that is due and leave out the forgotten one. Do not take two doses together to make up for a missed one.
Getting the most from your treatment
- Try to keep all your regular appointments with your doctor. This is so your doctor can check on your progress. You will need to have regular blood tests while on bosentan to check that you do not develop anaemia. Your doctor will also want to check that your liver stays healthy. Signs that your liver may not be working properly are feeling sick, a high temperature, dark urine, jaundice, stomach pain, feeling unusually tired, and flu-like symptoms - let your doctor know straightaway if you notice any of these.
- You must avoid getting pregnant while you are taking bosentan because it can cause harm to an unborn baby. Make sure you discuss with your doctor which types of contraception are suitable for you, as some hormonal contraceptives (such as 'the pill') are not sufficiently reliable. If you could become pregnant, your doctor will ask you to have a pregnancy test before you start taking bosentan, and regularly during treatment.
- If you are due to have an operation or some other medical treatment, it is important that you tell the person carrying out the treatment that you are taking bosentan.
- If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take.
- Keep taking these tablets until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor may want you to reduce your dose gradually if this is necessary.
Can bosentan cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with bosentan tablets. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common bosentan side-effects - these affect more than 1 in 10 people who take this medicine||What can I do if I experience this?|
|Headache||Ask your doctor or pharmacist to recommend a suitable painkiller|
|Swollen feet or ankles, fluid retention||If this becomes troublesome, speak with your doctor|
|Common bosentan side-effects - these affect less than 1 in 10 people who take this medicine||What can I do if I experience this?|
|Feeling dizzy||If this happens, do not drive or use tools or machines|
|Gastric reflux, diarrhoea||Avoid rich or spicy food. Drink plenty of water to replace any lost fluids|
|Palpitations, flushing||If troublesome, speak with your doctor|
|Allergic-type reactions such as an itchy red rash||Let your doctor know as soon as possible|
|Changes to some blood tests||Your doctor will regularly check for these|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store bosentan
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, ®Tracleer® 62.5 mg film-coated tablets; Actelion Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated November 2012.
- British National Formulary; 65th Edition (Mar 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Helen Huins