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Drug Interactions between bedaquiline and TheraCys

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

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Interactions between your drugs

Major

BCG bedaquiline

Applies to: TheraCys (bcg) and bedaquiline

CONTRAINDICATED: Antituberculosis drugs may interfere with the anti-tumor activity of intravesical BCG, which contains a live, attenuated strain of Mycobacterium bovis. Available data suggest that intravesical BCG may be sensitive to most antibiotics, particularly those that are routinely used in the treatment of tuberculosis such as streptomycin, para-aminosalicylic acid (PAS), isoniazid (INH), rifampin, and ethambutol. It is reportedly not sensitive to pyrazinamide or cycloserine. Regardless of clinical susceptibility data, however, most antibacterials may still interfere with BCG in the bladder due to their high urinary recovery.

MANAGEMENT: Concomitant use of antituberculosis drugs is considered contraindicated during intravesical BCG therapy. Moreover, intravesical BCG should not be used in patients with active tuberculosis. If persistent fever develops or an acute febrile illness consistent with BCG infection occurs during intravesical BCG therapy, the medication should be permanently discontinued and the patient immediately evaluated and treated for BCG infection. An infectious disease consultation should be sought in determining the appropriate treatment. There are no data to suggest that the acute, local urinary tract toxicity common with intravesical administration of BCG is due to mycobacterial infection, thus antituberculosis drugs should not be used to prevent or treat the local, irritative toxicities of intravesical BCG.

References

  1. "Product Information. Tice BCG Live (for intravesical use) (BCG)." Organon
  2. Durek C, Rusch-Gerdes S, Jocham D, Bohle A (1999) "Interference of modern antibacterials with bacillus Calmette-Guerin viability." J Urol, 162, p. 1959-62
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Cerner Multum, Inc. "Australian Product Information."
  5. "Product Information. Tice BCG Live (for intravesical use) (BCG)." Organon Pharmaceuticals
View all 5 references

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Drug and food interactions

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.

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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

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