Drug interactions
Berotralstat + Quinidine
Severity: Major
Berotralstat 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
Berotralstat inhibits P-gp and CYP3A4, both involved in quinidine disposition, and can increase quinidine levels. Quinidine may also raise berotralstat via P-gp inhibition. Elevated quinidine exposure increases the risk of QT prolongation and arrhythmia, and berotralstat itself prolongs QT at higher doses.
What this interaction means in plain words
Berotralstat 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.
Berotralstat belongs to Miscellaneous; Quinidine belongs to Anti Parasitic.
Why it happens
Berotralstat inhibits P-gp and CYP3A4, reducing quinidine clearance, while quinidine inhibits P-gp efflux of berotralstat.
What to do
Monitor ECG QTc and quinidine concentrations, and reduce the quinidine dose if levels or QTc rise; consider an alternative antiarrhythmic.
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 Berotralstat
Frequently asked questions
Can I take Berotralstat with Quinidine?
MediHelp rates the interaction as major. Berotralstat 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. Berotralstat inhibits P-gp and CYP3A4, both involved in quinidine disposition, and can increase quinidine levels. Quinidine may also raise berotralstat via P-gp inhibition. Elevated quinidine exposure increases the risk of QT prolongation and arrhythmia, and berotralstat itself prolongs QT at higher doses.
How serious is the interaction between Berotralstat 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: Monitor ECG QTc and quinidine concentrations, and reduce the quinidine dose if levels or QTc rise; consider an alternative antiarrhythmic.
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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