Drug interactions
Epinephrine racemic + Fluticasone-salmeterol
Severity: Moderate
Epinephrine racemic 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
Salmeterol and racemic epinephrine are both beta-adrenergic agonists, so using them together can cause additive tachycardia, palpitations, tremor, raised blood pressure and a fall in serum potassium. Patients with cardiovascular disease are at greater risk of arrhythmia.
What this interaction means in plain words
Epinephrine racemic 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.
Why it happens
Additive beta-adrenergic stimulation with beta2-mediated intracellular potassium shift.
What to do
Monitor heart rate, blood pressure and serum potassium, especially with frequent or high-dose epinephrine. Avoid unnecessary additional sympathomimetic doses in patients with cardiac disease.
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
Frequently asked questions
Can I take Epinephrine racemic with Fluticasone-salmeterol?
MediHelp rates the interaction as moderate. Epinephrine racemic 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. Salmeterol and racemic epinephrine are both beta-adrenergic agonists, so using them together can cause additive tachycardia, palpitations, tremor, raised blood pressure and a fall in serum potassium. Patients with cardiovascular disease are at greater risk of arrhythmia.
How serious is the interaction between Epinephrine racemic 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: Monitor heart rate, blood pressure and serum potassium, especially with frequent or high-dose epinephrine. Avoid unnecessary additional sympathomimetic doses in patients with cardiac disease.
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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