Drug interactions
Bedaquiline + Mefloquine
Severity: Major
Bedaquiline and Mefloquine: 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 mefloquine and bedaquiline prolong the QT interval, and combined use can increase the risk of torsades de pointes. Risk is higher with hypokalemia, hypomagnesemia, bradycardia or structural heart disease.
What this interaction means in plain words
Bedaquiline and Mefloquine 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; Mefloquine belongs to Anti Parasitic.
Why it happens
Additive pharmacodynamic prolongation of cardiac repolarization (QT interval).
What to do
Avoid the combination where possible; if unavoidable, perform ECG at baseline and regularly during therapy and correct electrolytes. Stop or reconsider therapy 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Bedaquiline and Mefloquine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide 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 Mefloquine?
MediHelp rates the interaction as major. Bedaquiline and Mefloquine 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 mefloquine and bedaquiline prolong the QT interval, and combined use can increase the risk of torsades de pointes. Risk is higher with hypokalemia, hypomagnesemia, bradycardia or structural heart disease.
How serious is the interaction between Bedaquiline and Mefloquine?
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 unavoidable, perform ECG at baseline and regularly during therapy and correct electrolytes. Stop or reconsider therapy if QTc becomes markedly prolonged.
What other medicines interact with Mefloquine?
MediHelp also lists interactions of Mefloquine with, for example, Arsenic trioxide, Dronedarone, Ibutilide. The full list is on the Mefloquine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
