Interactions between Bedaquiline and Pasireotide

Pasireotide has a moderate potential interaction with Adrenal Insufficiency.

Treatment with somatostatin analogs may suppress the pituitary hormones other than GH/IGF-1. It is recommended to monitor pituitary function prior to initiation of therapy and periodically during treatment, as clinically appropriate. Patients should be monitored for and instructed on the signs and symptoms of adrenal insufficiency during therapy. If adrenal insufficiency is suspected it should be confirmed and treated per standard of care with exogenous glucocorticoids at replacement doses.

Bedaquiline has a moderate potential interaction with Alcoholism.

The use of bedaquiline might increase hepatic-related adverse events and lead to hepatotoxicity. It is recommended to avoid alcohol and other hepatotoxic drugs while on bedaquiline. Close monitoring is recommended in alcoholic patients as they are at a greater risk of hepatic toxicity. Liver function tests should be done at baseline, monthly while on treatment, and as needed thereafter and discontinuance of therapy if evidence of new or worsening liver dysfunction occurs as indicated by the manufacturer.

Pasireotide has a moderate potential interaction with Arrhythmia.

The use of pasireotide is associated with QT prolongation. Pasireotide should be used with caution in patients who are at significant risk of developing QT prolongation. It is recommended to correct levels of hypokalemia and hypomagnesemia prior to starting therapy with this agent. Assess ECG at the beginning of therapy and monitor during therapy. Care should be taken in predisposed patients.

Pasireotide has a moderate potential interaction with Diabetes Mellitus.

Elevations in blood glucose levels have been reported with the use of somatostatin analogs. Cushing's disease patients with poor glycemic control may be at a higher risk of developing severe hyperglycemia and associated complications, e.g., ketoacidosis. It is recommended to assess the glycemic status of hemoglobin A1C prior to starting treatment with these agents. Self-monitoring of blood glucose and/or FPG assessments should be done every week for the first two to three months and periodically thereafter, as clinically appropriate, as well as over the first two to four weeks after any dose increase. If uncontrolled hyperglycemia persists, despite appropriate medical management, the dose of these agents should be reduced or discontinued.

Bedaquiline has a major potential interaction with Electrolyte Abnormalities.

Bedaquiline can cause QT prolongation, which may lead to an increased risk for ventricular arrhythmias, including Torsade de Pointes. Use of bedaquiline should be avoided in patients with congenital long QT syndrome, known prolongation of the QTc interval, uncompensated heart failure, or severe left ventricular hypertrophy, hypothyroidism, and in patients with electrolytes abnormalities. It is recommended to obtain an ECG before initiation of treatment, and at least 2, 12, and 24 weeks after starting treatment and to discontinue treatment if significant ventricular arrhythmia or if QTcF interval prolongation of greater than 500 ms develops.

Pasireotide has a moderate potential interaction with Electrolyte Abnormalities.

The use of pasireotide is associated with QT prolongation. Pasireotide should be used with caution in patients who are at significant risk of developing QT prolongation. It is recommended to correct levels of hypokalemia and hypomagnesemia prior to starting therapy with this agent. Assess ECG at the beginning of therapy and monitor during therapy. Care should be taken in predisposed patients.

Pasireotide has a moderate potential interaction with Gallbladder Disease.

Somatostatin analogs may reduce gallbladder motility and lead to gallstones formation. It is recommended to assess the gallbladder prior to starting therapy and periodically thereafter.

Bedaquiline has a major potential interaction with Heart Disease.

Bedaquiline can cause QT prolongation, which may lead to an increased risk for ventricular arrhythmias, including Torsade de Pointes. Use of bedaquiline should be avoided in patients with congenital long QT syndrome, known prolongation of the QTc interval, uncompensated heart failure, or severe left ventricular hypertrophy, hypothyroidism, and in patients with electrolytes abnormalities. It is recommended to obtain an ECG before initiation of treatment, and at least 2, 12, and 24 weeks after starting treatment and to discontinue treatment if significant ventricular arrhythmia or if QTcF interval prolongation of greater than 500 ms develops.

Pasireotide has a moderate potential interaction with Heart Disease.

Bradycardia has been reported with the use of somatostatin analogs. It is recommended to carefully monitor patients with cardiac disorders for the development of bradycardia. Dose adjustments of beta-blockers, calcium channel blockers, or correction of electrolyte disturbances may be necessary. Care should be taken when initiating treatment with these agents in patients with bradycardia.

Pasireotide has a moderate potential interaction with Hypokalemia.

The use of pasireotide is associated with QT prolongation. Pasireotide should be used with caution in patients who are at significant risk of developing QT prolongation. It is recommended to correct levels of hypokalemia and hypomagnesemia prior to starting therapy with this agent. Assess ECG at the beginning of therapy and monitor during therapy. Care should be taken in predisposed patients.

Pasireotide has a major potential interaction with Liver Disease.

The use of pasireotide causes elevations in ALT or AST. No dose adjustment is required in patients with mild hepatic impairment, but is required for patients with moderate hepatic impairment. The use of pasireotide should be avoided in patients with severe hepatic impairment. Regular monitoring of liver function test is recommended and interruption of treatment should be considered if abnormal values exceeding 5 times ULN or rising values are obtained during the course of therapy.

Bedaquiline has a moderate potential interaction with Liver Disease.

Bedaquiline population pharmacokinetic analysis indicated that mild to moderate hepatic impairment had no significant influence on bedaquiline pharmacokinetics. Close monitoring of liver function is recommended in patients with severe hepatic impairment as the pharmacokinetics of bedaquiline is unknown in these patients.

Bedaquiline has a major potential interaction with Long QT Syndrome.

Bedaquiline causes QT prolongation. Use with drugs that prolong the QT interval may cause additive QT prolongation. Monitor ECG before initiation of treatment, and at least 2, 12, and 24 weeks after starting treatment and obtain serum potassium, calcium, and magnesium at baseline and correct if abnormal. Discontinue bedaquiline if significant ventricular arrhythmia or if QTcF interval prolongation of greater than 500 ms. develops. If syncope occurs, obtain an ECG to detect QT prolongation.

Bedaquiline has a major potential interaction with Long QT Syndrome.

Bedaquiline can cause QT prolongation, which may lead to an increased risk for ventricular arrhythmias, including Torsade de Pointes. Use of bedaquiline should be avoided in patients with congenital long QT syndrome, known prolongation of the QTc interval, uncompensated heart failure, or severe left ventricular hypertrophy, hypothyroidism, and in patients with electrolytes abnormalities. It is recommended to obtain an ECG before initiation of treatment, and at least 2, 12, and 24 weeks after starting treatment and to discontinue treatment if significant ventricular arrhythmia or if QTcF interval prolongation of greater than 500 ms develops.

Bedaquiline has a moderate potential interaction with Renal Dysfunction.

No dose adjustment is required for patients with mild or moderate renal impairment. Care should be exercised when using bedaquiline in patients with severe renal impairment or end-stage renal disease requiring hemodialysis or peritoneal dialysis. It is recommended to monitor patients closely for adverse events.

Bedaquiline has a major potential interaction with Underactive Thyroid.

Bedaquiline can cause QT prolongation, which may lead to an increased risk for ventricular arrhythmias, including Torsade de Pointes. Use of bedaquiline should be avoided in patients with congenital long QT syndrome, known prolongation of the QTc interval, uncompensated heart failure, or severe left ventricular hypertrophy, hypothyroidism, and in patients with electrolytes abnormalities. It is recommended to obtain an ECG before initiation of treatment, and at least 2, 12, and 24 weeks after starting treatment and to discontinue treatment if significant ventricular arrhythmia or if QTcF interval prolongation of greater than 500 ms develops.

Pasireotide has a moderate potential interaction with Underactive Thyroid.

Bradycardia has been reported with the use of somatostatin analogs. It is recommended to carefully monitor patients with cardiac disorders for the development of bradycardia. Dose adjustments of beta-blockers, calcium channel blockers, or correction of electrolyte disturbances may be necessary. Care should be taken when initiating treatment with these agents in patients with bradycardia.

Bedaquiline has a major potential interaction with Ventricular Arrhythmia.

Bedaquiline causes QT prolongation. Use with drugs that prolong the QT interval may cause additive QT prolongation. Monitor ECG before initiation of treatment, and at least 2, 12, and 24 weeks after starting treatment and obtain serum potassium, calcium, and magnesium at baseline and correct if abnormal. Discontinue bedaquiline if significant ventricular arrhythmia or if QTcF interval prolongation of greater than 500 ms. develops. If syncope occurs, obtain an ECG to detect QT prolongation.