Drug interactions
Fluticasone-salmeterol + Levoketoconazole
Severity: Major
Fluticasone-salmeterol and Levoketoconazole: 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
Levoketoconazole is a strong CYP3A4 inhibitor that can substantially raise salmeterol exposure and also prolongs the QT interval. This increases the risk of QT prolongation and arrhythmia, and fluticasone exposure may also rise.
What this interaction means in plain words
Fluticasone-salmeterol and Levoketoconazole 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; Levoketoconazole belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition reducing salmeterol and fluticasone clearance, plus additive QT effects.
What to do
Avoid the combination and use an alternative bronchodilator and corticosteroid. If unavoidable, monitor ECG, potassium and for corticosteroid toxicity.
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 Levoketoconazole
- Alfuzosin + Levoketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Amiodarone + Levoketoconazole Contraindicated
- Avanafil + Levoketoconazole Contraindicated
- Cisapride + Levoketoconazole Contraindicated
- Clarithromycin + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Fluticasone-salmeterol with Levoketoconazole?
MediHelp rates the interaction as major. Fluticasone-salmeterol and Levoketoconazole 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. Levoketoconazole is a strong CYP3A4 inhibitor that can substantially raise salmeterol exposure and also prolongs the QT interval. This increases the risk of QT prolongation and arrhythmia, and fluticasone exposure may also rise.
How serious is the interaction between Fluticasone-salmeterol and Levoketoconazole?
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 and use an alternative bronchodilator and corticosteroid. If unavoidable, monitor ECG, potassium and for corticosteroid toxicity.
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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