Drug interactions
Fluticasone-salmeterol + Nefazodone
Severity: Major
Fluticasone-salmeterol and Nefazodone: 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
Nefazodone is a strong CYP3A4 inhibitor and can raise salmeterol and fluticasone concentrations. This increases the risk of tachycardia, QT prolongation and systemic corticosteroid effects.
What this interaction means in plain words
Fluticasone-salmeterol and Nefazodone 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 reducing clearance of salmeterol and fluticasone.
What to do
Avoid the combination if possible and use an alternative antidepressant or non-CYP3A4-dependent inhaled agents. If it is unavoidable, monitor ECG, heart rate and potassium.
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
Frequently asked questions
Can I take Fluticasone-salmeterol with Nefazodone?
MediHelp rates the interaction as major. Fluticasone-salmeterol and Nefazodone 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. Nefazodone is a strong CYP3A4 inhibitor and can raise salmeterol and fluticasone concentrations. This increases the risk of tachycardia, QT prolongation and systemic corticosteroid effects.
How serious is the interaction between Fluticasone-salmeterol and Nefazodone?
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 if possible and use an alternative antidepressant or non-CYP3A4-dependent inhaled agents. If it is unavoidable, monitor ECG, heart rate and potassium.
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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