Drug interactions
Bedaquiline + Dexamethasone
Severity: Moderate
Bedaquiline and Dexamethasone: moderate 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
Dexamethasone can induce CYP3A4, which is the main route of bedaquiline clearance. Lower bedaquiline exposure may reduce antimycobacterial efficacy in drug-resistant tuberculosis and risk treatment failure or resistance.
What this interaction means in plain words
Bedaquiline and Dexamethasone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Bedaquiline belongs to Anti Bacterial; Dexamethasone belongs to Endocrine.
Why it happens
Dexamethasone is a weak to moderate CYP3A4 inducer that increases the metabolism of bedaquiline.
What to do
Avoid prolonged systemic dexamethasone where possible, or monitor clinical and microbiological response to the TB regimen. Strong inducers such as rifampicin should be avoided; short courses of dexamethasone are generally less concerning.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine 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 Dexamethasone?
MediHelp rates the interaction as moderate. Bedaquiline and Dexamethasone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Dexamethasone can induce CYP3A4, which is the main route of bedaquiline clearance. Lower bedaquiline exposure may reduce antimycobacterial efficacy in drug-resistant tuberculosis and risk treatment failure or resistance.
How serious is the interaction between Bedaquiline and Dexamethasone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid prolonged systemic dexamethasone where possible, or monitor clinical and microbiological response to the TB regimen. Strong inducers such as rifampicin should be avoided; short courses of dexamethasone are generally less concerning.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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