Drug interactions
Fluoxetine + Salmeterol
Severity: Moderate
Fluoxetine and 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
Both drugs can prolong the QT interval, and salmeterol may also cause hypokalemia and tachycardia, which increase arrhythmia risk. The risk is greatest with high doses, electrolyte disturbance or underlying cardiac disease. At usual inhaled doses the absolute risk is low but not negligible.
What this interaction means in plain words
Fluoxetine and 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.
Fluoxetine belongs to Central Nervous System; Salmeterol belongs to Respiratory.
Why it happens
Additive QT prolongation, with beta2-agonist-induced hypokalemia and sympathetic stimulation adding to proarrhythmic risk.
What to do
Check baseline ECG and serum potassium and magnesium in patients with cardiac risk factors, and avoid exceeding recommended salmeterol doses. Consider alternatives if other QT-prolonging drugs are also used.
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 Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol Major
Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Salmeterol?
MediHelp rates the interaction as moderate. Fluoxetine and 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. Both drugs can prolong the QT interval, and salmeterol may also cause hypokalemia and tachycardia, which increase arrhythmia risk. The risk is greatest with high doses, electrolyte disturbance or underlying cardiac disease. At usual inhaled doses the absolute risk is low but not negligible.
How serious is the interaction between Fluoxetine and 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: Check baseline ECG and serum potassium and magnesium in patients with cardiac risk factors, and avoid exceeding recommended salmeterol doses. Consider alternatives if other QT-prolonging drugs are also used.
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.
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