It’s a moment that can feel overwhelming – hearing the words “tuberculosis” or “TB.” Your mind might race with questions, and that’s completely normal. One of the treatments we might discuss, especially if we’re dealing with a tougher-to-treat form of TB in the lungs, is a medication called Bedaquiline. You might also know it by its brand name, Sirturo. This medication is a powerful tool in our fight against certain TB infections, and understanding it is the first step towards feeling more in control.
What Exactly is Bedaquiline?
Think of Bedaquiline as a specialized antibiotic. It’s specifically designed to tackle Mycobacterium tuberculosis, the bacteria that causes TB. It’s not usually the first medication we reach for, but it plays a crucial role when other TB drugs might not be effective enough, particularly in cases of multidrug-resistant TB (MDR-TB). We use it as part of a combination therapy, meaning you’ll likely be taking it alongside other medications.
Before We Start Bedaquiline: What I Need to Know
Before we decide if Bedaquiline is the right path for you, it’s really important we have a good chat. I’ll need to know about your health history, so please tell me if you have or have had:
- Any heart conditions, including a history of an irregular heartbeat (sometimes called arrhythmia).
- A history of low levels of potassium, calcium, or magnesium in your blood.
- HIV or AIDS, as this can affect treatment choices.
- If you drink alcohol regularly, as this can interact with the medication or affect your liver.
- Any liver disease or concerns about your liver function.
- Any thyroid disease.
- Any unusual or allergic reactions to Bedaquiline itself, or to other medicines, foods, dyes, or preservatives in the past.
- If you’re pregnant, planning to become pregnant, or are currently breastfeeding. This is very important for us to discuss.
This information helps us make the safest and most effective plan for you.
How You’ll Take Bedaquiline
Taking Bedaquiline correctly is key to its success. Here’s what you can generally expect:
- You’ll take the tablet by mouth with a full glass of water.
- It’s important to take Bedaquiline with food. This helps your body absorb it properly.
- Because TB treatment is so critical, you’ll often take this medication under the supervision of a healthcare professional, or as part of a structured treatment program. This is to ensure you get the best possible results. This is often called Directly Observed Therapy (DOT).
- Stick to the schedule! Take your medicine at regular intervals as we’ve discussed. Don’t take it more often than directed.
- Finish the entire course. Even if you start feeling better (and I hope you do!), it’s vital to complete the full treatment. Stopping early can allow the TB bacteria to become resistant, making it much harder to treat. So, no skipped doses or stopping early, okay?
Your pharmacist will give you a special MedGuide with each prescription and refill. Please, please read this carefully each time. It has important information specific to Bedaquiline.
A note for parents: If we’re considering this for a child (it can be prescribed for children as young as 5 years for certain situations), we’ll have a very detailed discussion about the specific precautions and why it’s being recommended.
What if you take too much? If you think you’ve taken too much Bedaquiline, it’s important to contact a poison control center or go to an emergency room right away.
And if you miss a dose? Sticking to your TB treatment schedule is really important. If you miss a dose or know you won’t be able to make an appointment where your medication is administered, please call your doctor or healthcare professional as soon as possible. We’ll figure out the best way to get you back on track.
| Interaction Type | Examples of Medications |
|---|---|
| DO NOT take Bedaquiline with these: | |
| These can cause serious problems. |
|
| Bedaquiline may also interact with these (Tell your doctor if you take any!): | |
| Antiviral medicines for HIV or AIDS | e.g., efavirenz |
| Certain other medications | Arsenic trioxide |
| Certain antibiotics | e.g., azithromycin, chloroquine, ciprofloxacin, clarithromycin, erythromycin, gemifloxacin, levofloxacin, moxifloxacin, norfloxacin, ofloxacin, pentamidine, rifampin, rifapentine, rifabutin |
| Certain medicines for fungal infections | e.g., fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole |
| Certain medicines for irregular heartbeat | e.g., amiodarone, disopyramide, dofetilide, ibutilide, procainamide, propafenone, quinidine, sotalol |
| Certain medicines for nausea | e.g., chlorpromazine, droperidol |
| Certain medicines for psychotic disturbances | e.g., haloperidol |
| Other specific medications | Methadone, ziprasidone |
| Other medicines that prolong the QT interval | This is a specific type of abnormal heart rhythm risk. We’ll review all your meds. |
This isn’t a complete list, unfortunately. It’s so important to give us a full picture of everything you take: all prescribed medicines, over-the-counter drugs, herbal supplements, and even vitamins. Also, let us know if you smoke, drink alcohol, or use any recreational drugs, as these can also interact.
What to Keep an Eye On While Taking Bedaquiline
We’ll be monitoring you closely, but you’re our first line of defense!
- Let your doctor or healthcare professional know if your TB symptoms don’t seem to be improving, or if they actually get worse.
- You’ll need regular check-ups and blood tests while you’re on Bedaquiline. These help us make sure the medication is working and isn’t causing any problems, especially for your liver and heart.
- Breastfeeding: If you are breastfeeding, we need to talk. If you do breastfeed while taking Bedaquiline, and you notice your baby has darker urine or lighter-colored stools than usual, or if their skin or eyes look yellow, please tell your healthcare provider right away.
| When to Call Your Doctor or Healthcare Professional | Symptoms |
|---|---|
| Report these AS SOON AS POSSIBLE: | |
| Allergic Reactions |
|
| Lung-Related |
|
| Heart Rhythm Changes (QT prolongation) |
|
| Signs of Liver Injury |
|
| Report these if they continue or are bothersome: | |
| Common, Usually Milder Side Effects |
|
This list doesn’t cover every single possibility, but these are the main ones to be aware of. If anything feels off or worries you, it’s always best to call your doctor. You can also report side effects to the FDA if you wish.
Storing Your Medication Safely
- Keep Bedaquiline out of the reach of children. Always.
- Store it at room temperature, generally between 15 and 30 degrees C (that’s 59 and 86 degrees F).
- Keep the medicine in its original container.
- Once it’s past its expiration date, please dispose of any unused medicine safely. Your pharmacist can tell you how.
Take-Home Message
- Bedaquiline is a specialized antibiotic used with other drugs to treat certain types of lung tuberculosis (TB).
- Always take it with food and follow your doctor’s instructions precisely, completing the entire course.
- Inform your doctor about all other medications, supplements, and health conditions, especially heart or liver issues.
- Be aware of potential serious side effects, particularly those affecting your heart (QT prolongation) and liver, and report them immediately.
- Regular medical check-ups and blood tests are crucial during treatment with Bedaquiline.
- Never share your medication, and store it safely away from children.
Remember, this information is a summary. If you have questions about Bedaquiline or your TB treatment, please, talk to your doctor, pharmacist, or healthcare provider. We’re here to help you through this.
You’re not alone in this journey. We’ll work together to get you feeling better.