Other Brands/Names

Sirturo

How It Works

Bedaquiline is an antimycobacterial antibiotic used to treat multidrug-resistant tuberculosis (MDR-TB). This type of tuberculosis is a serious infection that primarily affects the lungs and other parts of the body and is resistant to at least two drugs typically used to treat pulmonary tuberculosis. Bedaquiline works by killing the bacteria responsible for the infection.

Indications

Bedaquiline is prescribed in combination with at least three other drugs to treat MDR-TB in adults and children 5 years old and older who weigh at least 15 kg. It is specifically used for treating MDR-TB that infects the lungs and should not be used for tuberculosis affecting organs other than the lungs.

Contraindications

Bedaquiline should not be used in individuals with a history of allergy or hypersensitivity to the drug.

Side Effects

Common side effects of bedaquiline include nausea, joint pain, and headaches. More serious side effects may include signs of liver damage, such as:

• Dark urine

• Nausea or vomiting

• Persistent loss of appetite

• Stomach pain

• Yellowing of the eyes or skin (jaundice)

Seek immediate medical help if you experience any of the following serious side effects:

• Coughing up blood

• Chest pain

• Fast or irregular heartbeat

• Severe dizziness

• Fainting

A very serious allergic reaction to bedaquiline is rare, but if you notice symptoms such as rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or difficulty breathing, get medical help immediately.

Types

Bedaquiline is available in 100 mg tablet form.

Dosage

Adult Dosage

When combined with three other anti-TB drugs:

• Weeks 1-2: 400 mg once daily

• Weeks 3-24: 200 mg three times weekly (with at least 48 hours between doses)

The medication must be administered under direct supervision by a trained healthcare worker or another designated person (excluding family members). The supervisor will provide the prescribed TB medication and ensure the patient swallows each dose.

Pediatric Dosage

Children (12-17 years old) with weight over 30 kg should receive the same dosage as adults. Treatment recommendations may vary by region or country, so consult local treatment guidelines.

Safety

• Avoid drinking alcohol while you are under bedaquiline treatments, as it can increase the risk of serious side effects like liver damage.
• Bedaquiline may also reduce the effectiveness of live bacterial vaccines (e.g., the typhoid vaccine).
• During pregnancy, it should only be used if clearly necessary; consult your doctor to assess the risks and benefits.
• The effects of bedaquiline during breastfeeding are unknown, so consult your doctor before breastfeeding.

Drug Interactions

• Bedaquiline may have reduced effectiveness when they are taken with:

  • The antituberculosis drug rifampin

  • The HIV antiviral efavirenz

  • The antiepileptic drugs carbamazepine and phenytoin

• Bedaquiline serum levels may increase when they are taken with:

  • The antifungal ketoconazole

  • The HIV antiviral ritonavir

  • The antibiotics ciprofloxacin and erythromycin (avoid concurrent use for more than 14 consecutive days unless necessary)

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