Bedaquiline and Fosamprenavir

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using bedaquiline together with fosamprenavir. Combining these medications can increase the blood levels and effects of bedaquiline. You may be more likely to develop uncommon but serious side effects such as irregular heart rhythm and liver damage. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should contact your doctor if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with bedaquiline. Also seek prompt medical attention if you develop signs and symptoms of liver damage such as fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of bedaquiline, which is primarily metabolized by CYP450 3A4 to its less active N-monodesmethyl metabolite, M2. In healthy volunteers, administration of bedaquiline (400 mg once daily for 14 days) in combination with ketoconazole (400 mg once daily for 4 days) increased bedaquiline peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin) by 9%, 22% and 33%, respectively, compared to administration alone. The potential for increased risk of adverse reactions should be considered, including prolongation of the QT interval and liver enzyme and bilirubin elevations.

MANAGEMENT: The concomitant use of potent CYP450 3A4 inhibitors such as clarithromycin, cobicistat, conivaptan, delavirdine, nefazodone, telithromycin, and most protease inhibitors and azole antifungal agents given systemically for more than 14 consecutive days should generally be avoided during treatment with bedaquiline unless the benefit is anticipated to outweigh the risk. Appropriate clinical monitoring for bedaquiline-related adverse reactions is recommended if coadministration is required. ECG, serum electrolytes (potassium, magnesium, calcium), and liver function tests (ALT, AST, alkaline phosphatase, bilirubin) should be monitored before starting bedaquiline therapy and periodically during treatment in accordance with the product labeling. Hypokalemia, hypomagnesemia, and hypocalcemia must be corrected prior to bedaquiline administration. Bedaquiline should be interrupted in patients who develop clinically significant ventricular arrhythmia or a QTcF interval greater than 500 msec confirmed by repeat ECG. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. Patients should also seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice.

Bedaquiline

Generic Name: bedaquiline

Brand name: Sirturo

Synonyms: Bedaquiline Fumarate

What is Bedaquiline?

Fosamprenavir

Generic Name: fosamprenavir

Brand name: Lexiva, Telzir

Synonyms: n.a.

What is Fosamprenavir?