Drug interactions
Fluticasone + Nelfinavir
Severity: Major
Fluticasone and Nelfinavir: 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
Nelfinavir inhibits the CYP3A4 enzyme that clears fluticasone, which raises systemic exposure to the corticosteroid. Prolonged co-use can cause Cushing's syndrome and adrenal suppression, even with intranasal or inhaled fluticasone.
What this interaction means in plain words
Fluticasone and Nelfinavir 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; Nelfinavir belongs to Anti Virals.
Why it happens
Nelfinavir inhibits CYP3A4-mediated first-pass and systemic metabolism of fluticasone.
What to do
Prefer an alternative corticosteroid less dependent on CYP3A4, such as beclomethasone, for long-term use. If the combination cannot be avoided, monitor for Cushingoid features 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 Nelfinavir
- Alfuzosin + Nelfinavir Contraindicated
- Avanafil + Nelfinavir Contraindicated
- Dronedarone + Nelfinavir Contraindicated
- Eletriptan + Nelfinavir Contraindicated
- Ergotamine + Nelfinavir Contraindicated
- Flibanserin + Nelfinavir Contraindicated
Frequently asked questions
Can I take Fluticasone with Nelfinavir?
MediHelp rates the interaction as major. Fluticasone and Nelfinavir 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. Nelfinavir inhibits the CYP3A4 enzyme that clears fluticasone, which raises systemic exposure to the corticosteroid. Prolonged co-use can cause Cushing's syndrome and adrenal suppression, even with intranasal or inhaled fluticasone.
How serious is the interaction between Fluticasone and Nelfinavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative corticosteroid less dependent on CYP3A4, such as beclomethasone, for long-term use. If the combination cannot be avoided, monitor for Cushingoid features 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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