Bosentan (Tracleer) Dosages: Your GoodRx Guide
Key takeaways:
Bosentan (Tracleer) is an oral medication that’s FDA approved to manage pulmonary arterial hypertension (PAH). It can be taken by adults and children ages 3 and older.
The typical bosentan dosage for PAH depends on your body weight. For people over 12 years old, the dosage ranges from 62.5 mg to 125 mg twice daily. For children ages 12 and under, the dosage ranges from 16 mg to 64 mg twice daily.
Bosentan interacts with many medications. You may need a different dose depending on what medications you currently take. Your healthcare team can help you manage potential interactions in advance.
Table of contents
Bosentan (Tracleer) is an oral medication used to manage pulmonary arterial hypertension (PAH). It’s an endothelin receptor antagonist that can help improve your exercise ability and slow the progression of PAH. Adults and children ages 3 and older can take bosentan.
The usual bosentan dosage for PAH depends on your body weight. And it can be influenced by other medications you’re taking, too. Here’s what you should know about typical bosentan dosages, including steps to take if you miss your dose.
What to expect when starting bosentan
When starting bosentan, you’ll be enrolled in a mandatory Risk Evaluation and Mitigation Strategy (REMS) program. This program helps manage potential risks of taking bosentan, including liver damage and harm to a growing fetus.
As part of the REMS program, your prescriber will check your liver health initially and every month while you take bosentan. If you’re able to get pregnant, you’ll also need to provide a negative pregnancy test before starting bosentan as well as each month thereafter. In this case, up to two effective forms of birth control are also required.
Good to know: Bosentan can interact with hormonal birth control, potentially making it less effective. Your healthcare team can recommend appropriate birth control methods for you.
How they compare: There are many medications available to manage pulmonary arterial hypertension (PAH). Learn about the different types of PAH medications and how they compare.
Guide to pulmonary arterial hypertension: Experts break down the different symptoms, causes, and treatments of PAH.
Portable oxygen therapy: Oxygen therapy can help with PAH symptoms such as shortness of breath. Learn more about portable oxygen options that allow you to use oxygen outside the home.
Bosentan dosage forms
Bosentan comes in oral tablets and tablets for oral suspension (dispersible tablets). The oral tablets are packaged in a bottle or blister strips. The dispersible tablets are packaged in blister strips. Both forms can be taken with or without food.
The oral bosentan tablets come in doses of 62.5 mg and 125 mg. These tablets are intended for people over 12 years old. The dispersible tablets come in a 32 mg dose and are scored into halves or quarters. These tablets are primarily intended for children ages 12 and under.
When taking the dispersible tablets, dilute your child’s dose in a small amount of water. Once diluted, the medication should be taken immediately. If you’re saving remaining tablet portions for future use, return them to the open blister and take it within 7 days.
What’s the typical bosentan dosage for adults?
The typical bosentan dosage for PAH in adults depends on body weight. For most people, the recommended starting dosage is 62.5 mg twice daily for 4 weeks.
After the first 4 weeks, your care team may increase your bosentan dosage to 125 mg twice daily if you weigh more than 40 kg (88 lbs). If you weigh less than 40 kg, you may be instructed to continue taking 62.5 mg twice daily.
What’s the typical bosentan dosage for children?
Bosentan is approved for children ages 3 and older. Children over 12 years old take the same dosage as adults. Use the 32 mg bosentan dispersible tablet for children ages 12 and under. The typical bosentan dosage for children ages 12 and under depends on body weight, as detailed in the table below.
Body weight | Recommended dose |
|---|---|
4-8 kg | 16 mg twice a day |
Over 8 kg-16 kg | 32 mg twice a day |
Over 16 kg-24 kg | 48 mg twice a day |
Over 24 kg-40 kg | 64 mg twice a day |
Are there any dosage adjustments for drug interactions?
Bosentan is broken down in the body by certain liver enzymes. Medications that decrease the activity of these enzymes can affect how bosentan is broken down, causing it to build up. Some of these medications shouldn’t be taken with bosentan, such as cyclosporine (Sandimmune, Neoral, Gengraf) and glyburide.
Other bosentan interactions may require monitoring as well as dosage adjustments, including:
Ritonavir (Norvir)
Antifungal medications like ketoconazole or fluconazole (Diflucan)
Amiodarone (Pacerone)
Erythromycin
Diltiazem (Cardizem)
Make sure to share a complete list of the medications you take with your care team. They can determine how to manage potential interactions.
What happens if you miss a dose of bosentan?
Bosentan works best when you take it as recommended by your care team. But if you forget your dose, don’t stress. Take it as soon as you remember unless it’s almost time for the next dose.
In that case, skip the missed dose and take your tablet at your regular time. Don’t double your dose. It’s not safe and could increase your risk of experiencing side effects from your medication.
To help you remember to take your bosentan dose on time, make it part of your morning and evening routines. For example, you can keep your medication by your bed or in a spot you can easily see. Just make sure it’s out of reach of children and pets. Take it first thing in the morning and at night. You can also set daily reminders on your phone or use a medication reminder app.
What should you do if you take too much bosentan?
If you take too much bosentan, you’re more likely to experience side effects. Depending on how much you take, you may experience headaches, nausea, and vomiting. Low blood pressure, dizziness, and sweating are also possible.
If you think you took too much bosentan, contact your care team right away or go to the nearest ER. You can also contact Poison Control at 1-800-222-1222. They can guide you through the situation and help you figure out how to manage your symptoms.
The bottom line
The typical bosentan (Tracleer) dosage for pulmonary arterial hypertension (PAH) depends on your body weight. For adults and children over 12 years old, this typically ranges from 62.5 mg to 125 mg twice daily. For children ages 12 and under, it ranges from 16 mg to 64 mg twice daily.
Talk to your healthcare team if you have any questions about your bosentan dosage.
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References
Actelion Pharmaceuticals US, Inc. (2024). Tracleer (bosentan) tablets, for oral use; Tracleer (bosentan) tablets, for oral suspension [package insert].
MedlinePlus. (2024). Bosentan.
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