Drug interactions
Berotralstat + Quinine
Severity: Major
Berotralstat 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
Berotralstat inhibits CYP3A4 and P-glycoprotein, both of which affect quinine clearance, so quinine levels may rise. Berotralstat itself also prolongs the QT interval at higher doses, and quinine is a P-gp inhibitor that may raise berotralstat levels.
What this interaction means in plain words
Berotralstat 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.
Berotralstat belongs to Miscellaneous; Quinine belongs to Anti Parasitic.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein by berotralstat reduces quinine clearance, with additive QT effects.
What to do
Avoid if possible because of the QT risk. If required, obtain an ECG, monitor for quinine toxicity such as cinchonism, and correct electrolytes.
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 Berotralstat
Frequently asked questions
Can I take Berotralstat with Quinine?
MediHelp rates the interaction as major. Berotralstat 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. Berotralstat inhibits CYP3A4 and P-glycoprotein, both of which affect quinine clearance, so quinine levels may rise. Berotralstat itself also prolongs the QT interval at higher doses, and quinine is a P-gp inhibitor that may raise berotralstat levels.
How serious is the interaction between Berotralstat 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: Avoid if possible because of the QT risk. If required, obtain an ECG, monitor for quinine toxicity such as cinchonism, and correct electrolytes.
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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