Drug interactions
Bedaquiline + Flecainide
Severity: Major
Bedaquiline and Flecainide: 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 flecainide can slow conduction and also affect repolarization. Using them together raises the risk of serious ventricular arrhythmias.
What this interaction means in plain words
Bedaquiline and Flecainide 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; Flecainide belongs to Cardiovascular.
Why it happens
Additive QT prolongation and cardiac ion channel effects.
What to do
Avoid the combination where possible. If it is essential, perform ECG monitoring at baseline and regularly during treatment and keep potassium, magnesium and calcium within normal ranges.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir 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 Flecainide?
MediHelp rates the interaction as major. Bedaquiline and Flecainide 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 flecainide can slow conduction and also affect repolarization. Using them together raises the risk of serious ventricular arrhythmias.
How serious is the interaction between Bedaquiline and Flecainide?
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 the combination where possible. If it is essential, perform ECG monitoring at baseline and regularly during treatment and keep potassium, magnesium and calcium within normal ranges.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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