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Drug Interactions between bedaquiline and Thalomid

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

thalidomide bedaquiline

Applies to: Thalomid (thalidomide) and bedaquiline

MONITOR: Thalidomide can cause bradycardia and may have additive effects with other drugs that decrease heart rate. Cases of bradycardia have been associated with thalidomide use, some requiring medical interventions. The clinical significance and underlying etiology of the bradycardia observed with thalidomide treatment have not been established. However, the potential for additive bradycardic effects should be considered when used with other drugs that slow cardiac conduction such as beta-blockers, calcium channel blockers, digitalis, flecainide, moricizine, and propafenone. Non-cardiac drugs that may also cause bradycardia include atazanavir, lacosamide, lithium, mefloquine, succinylcholine, H2-receptor antagonists, tricyclic antidepressants, and anticholinesterase or cholinergic agents. Because bradycardia is a risk factor for torsade de pointes arrhythmia, concerns also exist when thalidomide is used with drugs that prolong the QT interval or cause torsade de pointes.

MANAGEMENT: Caution is advised when thalidomide is used with drugs that can slow the heart rate or induce torsade de pointes arrhythmia. Patients should be monitored for bradycardia, atrioventricular block and syncope, and advised to seek medical attention if they experience dizziness, lightheadedness, fainting, shortness of breath, or slow or irregular heartbeat. A dose reduction of thalidomide or discontinuation may be required.

References

  1. (2001) "Product Information. Thalomid (thalidomide)." Celgene Corporation
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."

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Drug and food interactions

Moderate

thalidomide food

Applies to: Thalomid (thalidomide)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Moderate

bedaquiline food

Applies to: bedaquiline

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.

References

  1. (2013) "Product Information. Sirturo (bedaquiline)." Janssen Pharmaceuticals

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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