Drug interactions
Fluticasone inhaled + Itraconazole
Severity: Major
Fluticasone inhaled and Itraconazole: 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
Itraconazole can markedly increase systemic fluticasone exposure, leading to Cushing syndrome and adrenal suppression, mostly with prolonged use. Cases have been reported with other strong CYP3A4 inhibitors.
What this interaction means in plain words
Fluticasone inhaled and Itraconazole 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
Strong CYP3A4 inhibition blocks the extensive first-pass and systemic metabolism of fluticasone.
What to do
Avoid long-term co-use where possible, and switch to beclomethasone or another less CYP3A4-dependent corticosteroid. If unavoidable, 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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Fluticasone inhaled with Itraconazole?
MediHelp rates the interaction as major. Fluticasone inhaled and Itraconazole 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. Itraconazole can markedly increase systemic fluticasone exposure, leading to Cushing syndrome and adrenal suppression, mostly with prolonged use. Cases have been reported with other strong CYP3A4 inhibitors.
How serious is the interaction between Fluticasone inhaled and Itraconazole?
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 co-use where possible, and switch to beclomethasone or another less CYP3A4-dependent corticosteroid. If unavoidable, monitor for Cushingoid features and adrenal suppression.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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