Drug interactions
Bedaquiline + Fluconazole
Severity: Major
Bedaquiline and Fluconazole: 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 can prolong the QT interval, and fluconazole as a CYP3A4 inhibitor may also raise bedaquiline exposure. This increases the risk of torsades de pointes, especially with electrolyte disturbances or other QT-prolonging agents.
What this interaction means in plain words
Bedaquiline and Fluconazole 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; Fluconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation, with fluconazole inhibiting CYP3A4 metabolism of bedaquiline.
What to do
Obtain a baseline ECG and monitor it regularly, and correct potassium, magnesium and calcium. Avoid the combination if an alternative antifungal is possible, or stop 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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole 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 Fluconazole?
MediHelp rates the interaction as major. Bedaquiline and Fluconazole 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 can prolong the QT interval, and fluconazole as a CYP3A4 inhibitor may also raise bedaquiline exposure. This increases the risk of torsades de pointes, especially with electrolyte disturbances or other QT-prolonging agents.
How serious is the interaction between Bedaquiline and Fluconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor it regularly, and correct potassium, magnesium and calcium. Avoid the combination if an alternative antifungal is possible, or stop if QTc becomes markedly prolonged.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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