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Updated November 2019
Bosentan (brand name Tracleer®) is a medicine used to treat a condition called pulmonary arterial hypertension (PAH). This is a condition where there is increased pressure in the arteries that carry blood from the heart to the lungs.
PAH can occur in a number of rheumatological diseases such as scleroderma. These diseases can cause thickening of the blood vessel walls. Symptoms include shortness of breath during routine activity (such as climbing stairs), tiredness and chest pain.
Bosentan helps lower blood pressure in the lungs by preventing thickening of the blood vessel walls. This helps your heart pump blood more efficiently through the blood vessels in the lungs.
Bosentan can reduce the symptoms of PAH and in some cases prolong life expectancy. It may take 2 months or more before your symptoms start to improve.
Before bosentan can be prescribed, a specialist will assess you. This may be a rheumatologist, immunologist, cardiologist (heart) or a respiratory (lung) physician who has experience in managing PAH.
You will be asked to have the following tests:
Every six months you will be asked to have the echocardiogram and the 6MWT to check that bosentan is still helping your condition.
Bosentan is a tablet. It comes in two strengths (62.5 mg and 125mg).
For the first month the dose is one 62.5 mg tablet twice a day. If tests to check blood counts and liver function are satisfactory the dose is then increased to one 125mg tablet twice a day.
Bosentan should be taken at the same time each day. It is usually taken in the morning and at night. If you forget to take a dose you can take it later in the day. If it is the next day, take the normal dose (do not take a double dose). Bosentan does not have to be taken with food.
Bosentan may be taken in combination with other medicines including:
There are a number of medicines that should not be taken when you are taking bosentan (see Precautions).
Bosentan may be given on a long term basis provided it does not cause problems and continues to help your condition. It is usually given for as long as the 6-monthly tests (echocardiogram and the 6MWT) show that it is of benefit.
Do not stop taking bosentan without first talking to your doctor. If your doctor does decide to stop the treatment, you may need to reduce the dose gradually before you stop the medicine completely.
Most people who take bosentan do not experience side effects. Tell your doctor if you are concerned about possible side effects. A reduction in dose may minimise the side effects so that you can continue to have this treatment.