Drug interactions
Bedaquiline + Isoniazid
Severity: Moderate
Bedaquiline and Isoniazid: 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
Isoniazid is often used with bedaquiline in tuberculosis regimens. Its CYP3A4 inhibition is weak and may modestly raise bedaquiline exposure, which matters because of QT prolongation and hepatotoxicity, both of which can also be caused by the regimen.
What this interaction means in plain words
Bedaquiline and Isoniazid 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; Isoniazid belongs to Anti Bacterial.
Why it happens
Isoniazid may weakly inhibit CYP3A4, reducing bedaquiline metabolism, and both drugs can cause hepatotoxicity.
What to do
Obtain baseline and periodic ECGs, electrolytes and liver tests during combined therapy. The combination is standard in regimens, so no routine avoidance is needed.
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 Isoniazid
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 Isoniazid?
MediHelp rates the interaction as moderate. Bedaquiline and Isoniazid 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. Isoniazid is often used with bedaquiline in tuberculosis regimens. Its CYP3A4 inhibition is weak and may modestly raise bedaquiline exposure, which matters because of QT prolongation and hepatotoxicity, both of which can also be caused by the regimen.
How serious is the interaction between Bedaquiline and Isoniazid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain baseline and periodic ECGs, electrolytes and liver tests during combined therapy. The combination is standard in regimens, so no routine avoidance is needed.
What other medicines interact with Isoniazid?
MediHelp also lists interactions of Isoniazid with, for example, Bacillus calmette-guerin substrain tice, Benzhydrocodone / acetaminophen, Carbamazepine. The full list is on the Isoniazid page.
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