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Drug interactions

Bedaquiline + Erythromycin

Severity: Major

Bedaquiline and Erythromycin: 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

Both drugs prolong the QTc interval, so combined use raises the risk of torsades de pointes. Erythromycin also inhibits CYP3A4 and may raise bedaquiline concentrations, further increasing the risk.

What this interaction means in plain words

Bedaquiline and Erythromycin 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; Erythromycin belongs to Anti Bacterial.

Evidence level: Moderate

Why it happens

Additive QT prolongation plus CYP3A4 inhibition increasing bedaquiline exposure.

What to do

Avoid if an alternative antibiotic is available. If combined, obtain baseline and regular ECGs and correct potassium, magnesium and calcium.

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 Erythromycin?

MediHelp rates the interaction as major. Bedaquiline and Erythromycin 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. Both drugs prolong the QTc interval, so combined use raises the risk of torsades de pointes. Erythromycin also inhibits CYP3A4 and may raise bedaquiline concentrations, further increasing the risk.

How serious is the interaction between Bedaquiline and Erythromycin?

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 if an alternative antibiotic is available. If combined, obtain baseline and regular ECGs and correct potassium, magnesium and calcium.

What other medicines interact with Erythromycin?

MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.

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