Bedaquiline

MEDICATION TYPE

Antibiotic

INDICATIONS

Treatment of Mycobacterium abscessus infections.

DRUG INTERACTIONS

Antiarrhythmics
Risk of prolonged QT interval (eg, Amiodarone, Sotalol, Procainamide, Disopyramide and Quinidine).

Antiemetics
Increased risk of QT prolongation (eg, Domperidone, Metoclopramide, 5HT3 antagonists).

Antiretrovirals
Limited data.

Antidepressants, Tricyclic
Risk of prolonged QT interval.

Antipsychotics (thioridazine, haloperidol, chlorpromazine, trifluoperazine, Percycline, prochlorperazine, Fluphenazine, Sertindole and Pimozide)
Risk of prolonged QT interval.

Azole Antifungals (eg, Ketoconazole, Voriconazole, Itraconazole, fluconazole)
Increased exposure to Bedaquiline; avoid co-administration for more than 14 days.

Carbamazepine
Accelerated metabolism of Bedaquiline resulting in reduced effect; avoid co-administration.

Chloroquine and Hydroxychloroquine
Risk of prolonged QT interval.

Clofazimine
Risk of prolonged QT interval.

CYP3A4 inducers
Accelerated metabolism of Bedaquiline resulting in reduced effect; avoid co-administration.

CYP3A4 inhibitors
Reduced metabolism resulting in increased serum concentrations of Bedaquiline; avoid prolonged co-administration for more than 14 days.

Fluoroquinolones
Risk of prolonged QT interval.

Ivacaftor
Possible increased serum levels of Bedaquiline – monitor for increased adverse effects.

Macrolides
Risk of prolonged QT interval. Avoid co-administration for more than 14 days.

Orkambi (Lumacaftor/Ivacaftor)
Accelerated metabolism of Bedaquiline, avoid co-administration.

Phenytoin
Accelerated metabolism of Bedaquiline resulting in reduced effect. Avoid co-administration.

Irifampicin, Rifabutin and Rifapentine
Accelerated metabolism of Bedaquiline resulting in reduced effect. Avoid co-administration.

Statins
Avoid co administration.

NOTES

Baseline and serial ECG; monitor LFTs. Specialist use only.