Drug interactions
Bedaquiline + Quinine
Severity: Major
Bedaquiline and Quinine: 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
Quinine and bedaquiline both prolong the QT interval, so combined use can lead to additive effects and a greater risk of torsades de pointes. The risk is higher with electrolyte abnormalities, bradycardia or cardiac disease.
What this interaction means in plain words
Bedaquiline and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation through cardiac potassium channel blockade.
What to do
Monitor ECGs at baseline and regularly during therapy, and correct hypokalemia, hypomagnesemia and hypocalcemia. Avoid the combination if the QTc becomes markedly prolonged or syncope occurs.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine 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 Quinine?
MediHelp rates the interaction as major. Bedaquiline and Quinine 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. Quinine and bedaquiline both prolong the QT interval, so combined use can lead to additive effects and a greater risk of torsades de pointes. The risk is higher with electrolyte abnormalities, bradycardia or cardiac disease.
How serious is the interaction between Bedaquiline and Quinine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECGs at baseline and regularly during therapy, and correct hypokalemia, hypomagnesemia and hypocalcemia. Avoid the combination if the QTc becomes markedly prolonged or syncope occurs.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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