Drug interactions
Bedaquiline + Buprenorphine
Severity: Major
Bedaquiline and Buprenorphine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bedaquiline prolongs the QT interval and buprenorphine has a modest additional effect. The combination may increase torsades risk, especially with other risk factors, and is relevant in patients with tuberculosis who are also on opioid substitution therapy.
What this interaction means in plain words
Bedaquiline and Buprenorphine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Bedaquiline belongs to Anti Bacterial; Buprenorphine belongs to Musculoskeletal.
Why it happens
Additive QT prolongation.
What to do
Monitor ECG at baseline and regularly during therapy, and keep potassium, calcium and magnesium normal. Stop or change therapy if QTc becomes markedly prolonged.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
Other interactions of Bedaquiline
- Bedaquiline + Ziprasidone Contraindicated
- Alfuzosin + Bedaquiline Major
- Amiodarone + Bedaquiline Major
- Amisulpride + Bedaquiline Major
- Amitriptyline + Bedaquiline Major
- Amobarbital + Bedaquiline Major
Frequently asked questions
Can I take Bedaquiline with Buprenorphine?
MediHelp rates the interaction as major. Bedaquiline and Buprenorphine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Bedaquiline prolongs the QT interval and buprenorphine has a modest additional effect. The combination may increase torsades risk, especially with other risk factors, and is relevant in patients with tuberculosis who are also on opioid substitution therapy.
How serious is the interaction between Bedaquiline and Buprenorphine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG at baseline and regularly during therapy, and keep potassium, calcium and magnesium normal. Stop or change therapy if QTc becomes markedly prolonged.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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