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Drug interactions

Darunavir + Fluticasone-salmeterol

Severity: Contraindicated

Darunavir and Fluticasone-salmeterol: contraindicated 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

Darunavir, usually given with ritonavir or cobicistat, strongly inhibits CYP3A4 and markedly raises salmeterol exposure. This can cause QT prolongation, palpitations and arrhythmias. It also raises systemic fluticasone levels, with a risk of Cushing's syndrome and adrenal suppression.

What this interaction means in plain words

Darunavir and Fluticasone-salmeterol are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Darunavir belongs to Anti Virals; Fluticasone-salmeterol belongs to Respiratory.

Evidence level: High

Why it happens

Strong CYP3A4 inhibition by the boosted protease inhibitor reduces salmeterol and fluticasone clearance.

What to do

Avoid the combination and use a non-CYP3A4-dependent alternative such as a different LABA or ICS (e.g., beclomethasone). If unavoidable, monitor ECG, potassium and adrenal function.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Darunavir with Fluticasone-salmeterol?

MediHelp rates the interaction as contraindicated. Darunavir and Fluticasone-salmeterol are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Darunavir, usually given with ritonavir or cobicistat, strongly inhibits CYP3A4 and markedly raises salmeterol exposure. This can cause QT prolongation, palpitations and arrhythmias. It also raises systemic fluticasone levels, with a risk of Cushing's syndrome and adrenal suppression.

How serious is the interaction between Darunavir and Fluticasone-salmeterol?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a non-CYP3A4-dependent alternative such as a different LABA or ICS (e.g., beclomethasone). If unavoidable, monitor ECG, potassium and adrenal function.

What other medicines interact with Fluticasone-salmeterol?

MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Fosamprenavir, Indinavir. The full list is on the Fluticasone-salmeterol page.

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