Drug Interactions between bedaquiline and fecal microbiota spores, live

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of bedaquiline. When administered with a standard meal containing approximately 22 grams of fat (558 total Kcal), the relative bioavailability of bedaquiline increased by approximately 2-fold compared to administration under fasted conditions.

GENERALLY AVOID: Coadministration with alcohol may increase the risk of hepatotoxicity associated with the use of bedaquiline. In clinical trials, hepatic adverse drug reactions developed in more bedaquiline-treated patients than in those who received other drugs used to treat tuberculosis. In patients receiving bedaquiline or placebo in combination with other drugs used to treat multidrug-resistant tuberculosis, reversible aminotransferase elevations of at least 3 times the upper limit of normal developed more frequently in the bedaquiline treatment group [10.8%] than in the placebo group [5.7%].

MANAGEMENT: To ensure maximal oral absorption, bedaquiline should be taken with food. Patients should avoid alcohol use during treatment.

ADJUST DOSING INTERVAL: There are no data regarding the effects of concurrent administration of oral fecal microbiota spores with food.

MANAGEMENT: The manufacturer of the oral formulation of fecal microbiota recommends that patients should have no food or drink except for a small amount of water for at least 8 hours prior to the first dose of fecal microbiota spores. The second and third doses of fecal microbiota spores should be taken on an empty stomach prior to the first meal of the day.