Drug interactions
Fluticasone + Ketoconazole
Severity: Major
Fluticasone and Ketoconazole: major interaction.
Last updated Sources: US FDA label
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
Ketoconazole is a strong CYP3A4 inhibitor and increases systemic fluticasone exposure, with reduced cortisol levels demonstrated in studies. This raises the risk of Cushing syndrome and adrenal suppression.
What this interaction means in plain words
Fluticasone and Ketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Fluticasone belongs to Respiratory; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition by ketoconazole reduces fluticasone clearance.
What to do
Avoid long-term coadministration and consider an alternative corticosteroid such as beclometasone. If it cannot be avoided, monitor for signs of hypercortisolism and adrenal suppression.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Fluticasone
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Fluticasone with Ketoconazole?
MediHelp rates the interaction as major. Fluticasone and Ketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ketoconazole is a strong CYP3A4 inhibitor and increases systemic fluticasone exposure, with reduced cortisol levels demonstrated in studies. This raises the risk of Cushing syndrome and adrenal suppression.
How serious is the interaction between Fluticasone and Ketoconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid long-term coadministration and consider an alternative corticosteroid such as beclometasone. If it cannot be avoided, monitor for signs of hypercortisolism and adrenal suppression.
What other medicines interact with Fluticasone?
MediHelp also lists interactions of Fluticasone with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Fluticasone page.
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