Drug interactions
Fluticasone intranasal + Ketoconazole
Severity: Moderate
Fluticasone intranasal and Ketoconazole: moderate interaction.
Last updated
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 can raise systemic fluticasone exposure even from the intranasal route, leading to Cushing's syndrome and adrenal suppression with prolonged use.
What this interaction means in plain words
Fluticasone intranasal and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Ketoconazole inhibits CYP3A4 metabolism of fluticasone, increasing systemic bioavailability.
What to do
Monitor for signs of corticosteroid excess during prolonged co-therapy. Consider an alternative steroid such as beclomethasone if long-term use is needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 intranasal with Ketoconazole?
MediHelp rates the interaction as moderate. Fluticasone intranasal and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ketoconazole can raise systemic fluticasone exposure even from the intranasal route, leading to Cushing's syndrome and adrenal suppression with prolonged use.
How serious is the interaction between Fluticasone intranasal and Ketoconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for signs of corticosteroid excess during prolonged co-therapy. Consider an alternative steroid such as beclomethasone if long-term use is needed.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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