Idelalisib with Bedaquiline Interaction Details
Brand Names Associated with Idelalisib
- Idelalisib
- Zydelig®
Brand Names Associated with Bedaquiline
- Bedaquiline
- Sirturo®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 06, 2023
Interaction Effect
Increased bedaquiline exposure
Interaction Summary
Concomitant use of bedaquiline (a CYP3A4 substrate) with a strong CYP3A4 inhibitor may increase bedaquiline exposure and may increase the risk of bedaquiline adverse reactions. During a pharmacokinetic study in healthy volunteers, coadministration of bedaquiline and ketoconazole significantly increased bedaquiline AUC, Cmax, and minimum concentration. The concurrent use of bedaquiline with a systemic strong CYP3A4 inhibitor for more than 14 consecutive days should be avoided, unless the benefits of the drug combination outweigh the risks. If coadministration is required, use caution and monitor the patient closely for bedaquiline-related adverse effects.
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
The concomitant use of bedaquiline (a CYP3A4 substrate) with a potent CYP3A4 inhibitor may increase bedaquiline exposure. Concurrent use of bedaquiline with a systemic strong CYP3A4 inhibitor for more than 14 consecutive days should be avoided, unless the benefits of the drug combination outweigh the risks. If coadministration is required, use caution and monitor the patient closely for bedaquiline-related adverse effects.
Mechanism Of Interaction
Inhibition of CYP3A4-mediated metabolism of bedaquiline
Literature Reports
A) In a pharmacokinetic study in healthy subjects, the bedaquiline AUC at 24 hours, Cmax, and minimum concentration were increased by 22% (90% CI, 12% to 32%), 9% (90% CI, -2% to 21%), and 33% (90% CI, 24% to 43%), respectively, during coadministration of bedaquiline 400 mg/day for 14 days and ketoconazole 400 mg/day for 4 days .
Idelalisib Overview
-
Idelalisib is used along with another medication rituximab (Rituxan) to treat chronic lymphocytic leukemia (CLL; a type of cancer that begins in the white blood cells) in people whose cancer came back after receiving other cancer treatments. It is also used to treat certain types of follicular lymphoma (FL; a type of cancer that begins in the white blood cells) and small lymphocytic lymphoma (SLL:a type of cancer that begins in the white blood cells) in people whose cancer came back after being treated with at least 2 other cancer treatments. Idelalisib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps stop the spread of cancer cells.
Bedaquiline Overview
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Bedaquiline is used along with at least three other medications to treat multi-drug resistant tuberculosis (MDR-TB; a serious infection that affects the lungs and other parts of the body and that cannot be treated with other medications that are usually used to treat the condition) in adults and children 5 years and older who weigh at least 33 lbs (15 kg) that has affected the lungs. Bedaquiline should not be used to treat TB that mainly affects other parts of the body. Bedaquiline is in a class of medications called anti-mycobacterials. It works by killing the bacteria that cause MDR-TB.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.