Drug interactions
Fluticasone-salmeterol + Lefamulin
Severity: Major
Fluticasone-salmeterol and Lefamulin: major 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
Lefamulin inhibits CYP3A4 and can raise salmeterol exposure. Salmeterol and lefamulin can each affect cardiac repolarization, so the combination increases the risk of QT prolongation and arrhythmia.
What this interaction means in plain words
Fluticasone-salmeterol and Lefamulin 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; Lefamulin belongs to Anti Bacterial.
Why it happens
CYP3A4 inhibition by lefamulin raises salmeterol levels, with additive QT-prolonging potential.
What to do
Monitor ECG and correct hypokalemia and hypomagnesemia, especially with oral lefamulin. Consider a non-CYP3A4-dependent bronchodilator or an alternative antibiotic where possible.
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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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 Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimavanserin Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
Frequently asked questions
Can I take Fluticasone-salmeterol with Lefamulin?
MediHelp rates the interaction as major. Fluticasone-salmeterol and Lefamulin 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. Lefamulin inhibits CYP3A4 and can raise salmeterol exposure. Salmeterol and lefamulin can each affect cardiac repolarization, so the combination increases the risk of QT prolongation and arrhythmia.
How serious is the interaction between Fluticasone-salmeterol and Lefamulin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and correct hypokalemia and hypomagnesemia, especially with oral lefamulin. Consider a non-CYP3A4-dependent bronchodilator or an alternative antibiotic where possible.
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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