Drug interactions
Bedaquiline + Itraconazole
Severity: Major
Bedaquiline and Itraconazole: 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
Itraconazole raises bedaquiline exposure and both drugs can prolong the QT interval, increasing the risk of ventricular arrhythmia and hepatotoxicity with prolonged co-use.
What this interaction means in plain words
Bedaquiline and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
CYP3A4 inhibition by itraconazole increases bedaquiline exposure, with additive QT prolongation.
What to do
Avoid use beyond 14 consecutive days unless benefit outweighs risk. If combined, perform ECG and electrolyte monitoring and monitor liver tests.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole?
MediHelp rates the interaction as major. Bedaquiline and Itraconazole 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. Itraconazole raises bedaquiline exposure and both drugs can prolong the QT interval, increasing the risk of ventricular arrhythmia and hepatotoxicity with prolonged co-use.
How serious is the interaction between Bedaquiline and Itraconazole?
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 use beyond 14 consecutive days unless benefit outweighs risk. If combined, perform ECG and electrolyte monitoring and monitor liver tests.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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