Drug interactions
Fluticasone-salmeterol + Itraconazole
Severity: Major
Fluticasone-salmeterol 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 strongly inhibits CYP3A4, markedly increasing salmeterol exposure, and both drugs can prolong the QT interval. This can cause tachycardia, tremor, hypokalemia and ventricular arrhythmias. It may also increase fluticasone exposure and systemic corticosteroid effects.
What this interaction means in plain words
Fluticasone-salmeterol 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.
Fluticasone-salmeterol belongs to Respiratory; Itraconazole belongs to Anti Fungals.
Why it happens
CYP3A4 inhibition by itraconazole raises salmeterol and fluticasone levels, with additive QT prolongation.
What to do
Avoid the combination where possible and choose an alternative antifungal or bronchodilator. If unavoidable, monitor ECG, potassium and heart rate.
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-salmeterol
- Darunavir + Fluticasone-salmeterol Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone-salmeterol Contraindicated
- Fluticasone-salmeterol + Fosamprenavir Contraindicated
- Fluticasone-salmeterol + Indinavir Contraindicated
- Fluticasone-salmeterol + Lopinavir Contraindicated
- Fluticasone-salmeterol + Nelfinavir Contraindicated
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-salmeterol with Itraconazole?
MediHelp rates the interaction as major. Fluticasone-salmeterol 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 strongly inhibits CYP3A4, markedly increasing salmeterol exposure, and both drugs can prolong the QT interval. This can cause tachycardia, tremor, hypokalemia and ventricular arrhythmias. It may also increase fluticasone exposure and systemic corticosteroid effects.
How serious is the interaction between Fluticasone-salmeterol 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 the combination where possible and choose an alternative antifungal or bronchodilator. If unavoidable, monitor ECG, potassium and heart rate.
What other medicines interact with Fluticasone-salmeterol?
MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Fosamprenavir. The full list is on the Fluticasone-salmeterol page.
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