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(boe sen' tan)For female patients: Do not take bosentan if you are pregnant or plan to become pregnant. Bosentan may harm the fetus. If you are sexually active and able to become pregnant, you should not begin taking bosentan until a pregnancy test has shown that you are not pregnant. You must use a reliable method of birth control and be tested for pregnancy every month during your treatment. Hormonal contraceptives (birth control pills, patches, rings, shots, implants, and intrauterine devices) may not work well when used with bosentan and should not be used as your only method of birth control. Talk to your doctor about birth control methods that will work for you. Call your doctor immediately if you miss a period or think that you may be pregnant while you are taking bosentan. For male and female patients: Bosentan may cause liver damage. Tell your doctor if you have or have ever had liver disease. If you experience any of the following symptoms, call your doctor immediately: upset stomach, vomiting, fever, stomach pain, yellowing of the skin or eyes, or extreme tiredness. Keep all appointments with your doctor and the laboratory. Your doctor will order a blood test to be sure your liver is working normally before you start taking bosentan and every month during your treatment. Bosentan may damage the liver without causing symptoms. Regular blood tests are the only way to find liver damage before it becomes permanent and severe. Bosentan is not available at retail pharmacies. Your medication will be mailed to you from a central pharmacy. This program is required to be sure that all patients who receive the medication are tested for liver damage and pregnancy. Ask your doctor if you have any questions about how you will receive your medication. Talk to your doctor about the risks of taking bosentan.