• Pulmonary arterial hypertension:
    • <40 kg: Maintain dose at 62.5mg BD. Max: 125mg per day
    • >40 kg: 5mg BD *4/52 and then increased to maintenance of 125mg BD. Max 250mg BD
    • Reduce dose when discontinuing to 62.5mg BD *3-7 days
    • Monitor AST/ALT levels constantly

Tablet:

  • 62.5mg
  • 125mg

Take with or without food

Competitive antagonist of endothelin-1

It blocks endothelin receptors on vascular endothelium and smooth muscle resulting in inhibition of vasoconstrictive effects of endothelin-1 thereby reducing pulmonary vascular resistance

  • URI
  • Decreased Hb
  • Headache
  • Peripheral edema
  • Syncope
  • Flushing
  • Hypotension
  • Sinusitis
  • Arthralgia
  • Elevated ALT/ AST
  • Palpitations
  • Anemia
  • Decreased sperm count
  • Hypersensitivity to class/components
  • Pregnancy
  • ALT or AST >3x ULN
  • Hepatic impairment
  • Pulmonary veno-occlusive disease
  • Anemia
  • Avoid abrupt withdrawal

WARNING:

  • Risk of hepatotoxicity: Avoid in patients with elevated aminotransferase levels (>3X ULN)
  • Negative pregnancy test result required before initiating & prevention of pregnancy required thereafter due to serious birth defects associated with drug
  • Artemether/lumefantrine
  • Cariprazine
  • Cobimetinib
  • Cyclosporine
  • Dienogest/estradiol valerate
  • Doravirine
  • Elvitegravir/cobicistat/emtricitabine/tenofovir
  • Fostemsavir
  • Glyburide
  • Isavuconazonium sulfate
  • Lonafarnib
  • Lorlatinib
  • Lumefantrine
  • Naloxegol
  • Ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)
  • Panobinostat
  • Praziquantel
  • Regorafenib
  • Roflumilast
  • Vandetanib

                          Drug Status

Availability Prescription only
Pregnancy Category X
Breastfeeding Contraindicated
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Bosetan 125mg Tablet 10’s Glenmark Pharma Glenmark Pharma
Bosetan 62.5mg Tablet 10’s Glenmark Pharma Glenmark Pharma
Pulmofirst 125 mg Tablet 10’s MSN Labs Simba Pharma
Pulmofirst 62.5mg Tablet 10’s MSN Labs Simba Pharma