Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone-salmeterol
Severity: Contraindicated
Elvitegravir / cobicistat / emtricitabine / tenofovir df 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
Cobicistat is a strong CYP3A4 inhibitor that increases salmeterol exposure, with risk of QT prolongation and arrhythmia. It also raises systemic fluticasone levels, so Cushing's syndrome and adrenal suppression can occur with prolonged use.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df 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.
Why it happens
Strong CYP3A4 inhibition by cobicistat reduces clearance of salmeterol and fluticasone.
What to do
Avoid the combination and consider an alternative such as beclomethasone with a non-CYP3A4-dependent LABA. If it cannot be avoided, 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?
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Other interactions of Fluticasone-salmeterol
- Darunavir + Fluticasone-salmeterol Contraindicated
- Fluticasone-salmeterol + Fosamprenavir Contraindicated
- Fluticasone-salmeterol + Indinavir Contraindicated
- Fluticasone-salmeterol + Lopinavir Contraindicated
- Fluticasone-salmeterol + Nelfinavir Contraindicated
- Fluticasone-salmeterol + Ritonavir Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Fluticasone-salmeterol?
MediHelp rates the interaction as contraindicated. Elvitegravir / cobicistat / emtricitabine / tenofovir df 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. Cobicistat is a strong CYP3A4 inhibitor that increases salmeterol exposure, with risk of QT prolongation and arrhythmia. It also raises systemic fluticasone levels, so Cushing's syndrome and adrenal suppression can occur with prolonged use.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df 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 consider an alternative such as beclomethasone with a non-CYP3A4-dependent LABA. If it cannot be avoided, monitor ECG, potassium and adrenal function.
What other medicines interact with Fluticasone-salmeterol?
MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Fosamprenavir, Indinavir. The full list is on the Fluticasone-salmeterol page.
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