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Drug interactions

Bedaquiline + Clarithromycin

Severity: Major

Bedaquiline and Clarithromycin: 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

Clarithromycin increases bedaquiline exposure, and both drugs can prolong the QT interval. This raises the risk of QT-related arrhythmias, especially with prolonged coadministration.

What this interaction means in plain words

Bedaquiline and Clarithromycin 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; Clarithromycin belongs to Anti Bacterial.

Evidence level: Moderate

Why it happens

CYP3A4 inhibition raising bedaquiline levels plus additive QT prolongation.

What to do

Avoid prolonged coadministration unless benefit outweighs risk. If used, monitor ECG regularly and keep electrolytes normal.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Bedaquiline with Clarithromycin?

MediHelp rates the interaction as major. Bedaquiline and Clarithromycin 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. Clarithromycin increases bedaquiline exposure, and both drugs can prolong the QT interval. This raises the risk of QT-related arrhythmias, especially with prolonged coadministration.

How serious is the interaction between Bedaquiline and Clarithromycin?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid prolonged coadministration unless benefit outweighs risk. If used, monitor ECG regularly and keep electrolytes normal.

What other medicines interact with Clarithromycin?

MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.

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