Drug interactions
Fluticasone furoate + Ritonavir
Severity: Major
Fluticasone furoate and Ritonavir: 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
Ritonavir strongly inhibits CYP3A4 and markedly raises systemic fluticasone exposure. Cushing syndrome and adrenal suppression have been reported with this combination, and fluticasone labeling advises against co-use unless benefit outweighs risk.
What this interaction means in plain words
Fluticasone furoate and Ritonavir 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
Ritonavir potently inhibits CYP3A4, greatly reducing fluticasone first-pass and systemic metabolism.
What to do
Avoid the combination where possible and use beclomethasone or another less CYP3A4-dependent corticosteroid; 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
Other interactions of Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Fluticasone furoate with Ritonavir?
MediHelp rates the interaction as major. Fluticasone furoate and Ritonavir 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. Ritonavir strongly inhibits CYP3A4 and markedly raises systemic fluticasone exposure. Cushing syndrome and adrenal suppression have been reported with this combination, and fluticasone labeling advises against co-use unless benefit outweighs risk.
How serious is the interaction between Fluticasone furoate and Ritonavir?
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 the combination where possible and use beclomethasone or another less CYP3A4-dependent corticosteroid; if co-used, monitor for Cushingoid features and adrenal suppression.
What other medicines interact with Ritonavir?
MediHelp also lists interactions of Ritonavir with, for example, Alfuzosin, Amiodarone, Avanafil. The full list is on the Ritonavir page.
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