Drug interactions
Atazanavir + Salmeterol
Severity: Major
Atazanavir and Salmeterol: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir is a strong CYP3A4 inhibitor and can substantially raise systemic salmeterol exposure. This increases the risk of QT prolongation, palpitations, tachycardia, tremor and hypokalemia.
What this interaction means in plain words
Atazanavir and Salmeterol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Salmeterol belongs to Respiratory.
Why it happens
Inhibition of CYP3A4-mediated first-pass and hepatic metabolism of salmeterol.
What to do
Avoid the combination where possible and use an alternative long-acting beta-agonist that is less dependent on CYP3A4, such as formoterol. If unavoidable, monitor ECG and potassium and watch for cardiovascular adverse effects.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Atazanavir and Salmeterol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Budesonide-formoterol + Salmeterol Major
- Carvedilol + Salmeterol Major
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Salmeterol?
MediHelp rates the interaction as major. Atazanavir and Salmeterol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir is a strong CYP3A4 inhibitor and can substantially raise systemic salmeterol exposure. This increases the risk of QT prolongation, palpitations, tachycardia, tremor and hypokalemia.
How serious is the interaction between Atazanavir and Salmeterol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use an alternative long-acting beta-agonist that is less dependent on CYP3A4, such as formoterol. If unavoidable, monitor ECG and potassium and watch for cardiovascular adverse effects.
What other medicines interact with Salmeterol?
MediHelp also lists interactions of Salmeterol with, for example, Ritonavir, Saquinavir, Amitriptyline. The full list is on the Salmeterol page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
