Drug interactions
Clozapine + Fluticasone-salmeterol
Severity: Moderate
Clozapine and Fluticasone-salmeterol: moderate 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
Clozapine can prolong the QTc and cause tachycardia and myocarditis, while salmeterol may add to heart rate and QTc effects, particularly at high doses or with hypokalemia. The combined arrhythmic risk is modest but relevant in patients with cardiac risk factors.
What this interaction means in plain words
Clozapine and Fluticasone-salmeterol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clozapine belongs to Central Nervous System; Fluticasone-salmeterol belongs to Respiratory.
Why it happens
Additive QTc prolongation and tachycardic effects from clozapine and the beta-2 agonist salmeterol.
What to do
Use standard salmeterol doses and monitor heart rate and ECG in patients with cardiac risk factors. Correct potassium and magnesium abnormalities.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fluticasone-salmeterol
- Darunavir + Fluticasone-salmeterol Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone-salmeterol Contraindicated
- Fluticasone-salmeterol + Fosamprenavir Contraindicated
- Fluticasone-salmeterol + Indinavir Contraindicated
- Fluticasone-salmeterol + Lopinavir Contraindicated
- Fluticasone-salmeterol + Nelfinavir Contraindicated
Other interactions of Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Clozapine with Fluticasone-salmeterol?
MediHelp rates the interaction as moderate. Clozapine and Fluticasone-salmeterol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Clozapine can prolong the QTc and cause tachycardia and myocarditis, while salmeterol may add to heart rate and QTc effects, particularly at high doses or with hypokalemia. The combined arrhythmic risk is modest but relevant in patients with cardiac risk factors.
How serious is the interaction between Clozapine and Fluticasone-salmeterol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use standard salmeterol doses and monitor heart rate and ECG in patients with cardiac risk factors. Correct potassium and magnesium abnormalities.
What other medicines interact with Fluticasone-salmeterol?
MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Fosamprenavir. The full list is on the Fluticasone-salmeterol page.
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