Drug interactions
Bedaquiline + Quinidine
Severity: Major
Bedaquiline and Quinidine: 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 is metabolized by CYP3A4 and itself prolongs the QT interval. Quinidine adds its own QT effect and may raise bedaquiline levels, increasing arrhythmia risk.
What this interaction means in plain words
Bedaquiline and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation, plus quinidine inhibition of CYP3A4 and P-glycoprotein reducing bedaquiline clearance.
What to do
Avoid if possible. If used together, monitor ECG at baseline and regularly, and keep electrolytes normal.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine 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 Quinidine?
MediHelp rates the interaction as major. Bedaquiline and Quinidine 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 is metabolized by CYP3A4 and itself prolongs the QT interval. Quinidine adds its own QT effect and may raise bedaquiline levels, increasing arrhythmia risk.
How serious is the interaction between Bedaquiline and Quinidine?
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 if possible. If used together, monitor ECG at baseline and regularly, and keep electrolytes normal.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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