Drug interactions
Fluticasone furoate + Lopinavir
Severity: Major
Fluticasone furoate and Lopinavir: major interaction.
Last updated Sources: UK SmPC
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
Lopinavir, given with ritonavir, inhibits CYP3A4 and can increase systemic fluticasone furoate exposure. Cushing syndrome and adrenal suppression have been reported with fluticasone and ritonavir-boosted regimens.
What this interaction means in plain words
Fluticasone furoate and Lopinavir 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.
Why it happens
Lopinavir/ritonavir inhibits CYP3A4, reducing first-pass and systemic clearance of fluticasone.
What to do
Prefer beclomethasone or another corticosteroid less dependent on CYP3A4 for long-term therapy; if co-used, 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
- Avamys 27.5 micrograms/spray, nasal spray suspension - SmPC sections 4.3/4.5 (class statement: potent CYP3A inhibitors; "Caution is recommended when co-administering fluticasone furoate with potent CYP3A inhibitors including cobicistat-containing products as an increase in the ris") — electronic medicines compendium (UK SmPC)
Other interactions of Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Fluticasone furoate with Lopinavir?
MediHelp rates the interaction as major. Fluticasone furoate and Lopinavir 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. Lopinavir, given with ritonavir, inhibits CYP3A4 and can increase systemic fluticasone furoate exposure. Cushing syndrome and adrenal suppression have been reported with fluticasone and ritonavir-boosted regimens.
How serious is the interaction between Fluticasone furoate and Lopinavir?
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 beclomethasone or another corticosteroid less dependent on CYP3A4 for long-term therapy; if co-used, monitor for Cushingoid features and adrenal suppression.
What other medicines interact with Lopinavir?
MediHelp also lists interactions of Lopinavir with, for example, Alfuzosin, Avanafil, Cisapride. The full list is on the Lopinavir page.
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