Drug interactions
Fluticasone-salmeterol + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Major
Fluticasone-salmeterol and Ombitasvir / paritaprevir / ritonavir and dasabuvir: 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
Ritonavir in this regimen strongly inhibits CYP3A4 and can greatly increase fluticasone exposure, leading to reduced cortisol levels, adrenal suppression and Cushing syndrome. Salmeterol exposure may also rise, increasing cardiovascular effects.
What this interaction means in plain words
Fluticasone-salmeterol and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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
Ritonavir-mediated CYP3A4 inhibition reducing metabolism of fluticasone and salmeterol.
What to do
Avoid the combination, especially for long-term use, and switch to an inhaled corticosteroid less affected by CYP3A4, such as beclomethasone. Monitor ECG and for corticosteroid excess if unavoidable.
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
Frequently asked questions
Can I take Fluticasone-salmeterol with Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as major. Fluticasone-salmeterol and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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. Ritonavir in this regimen strongly inhibits CYP3A4 and can greatly increase fluticasone exposure, leading to reduced cortisol levels, adrenal suppression and Cushing syndrome. Salmeterol exposure may also rise, increasing cardiovascular effects.
How serious is the interaction between Fluticasone-salmeterol and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
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, especially for long-term use, and switch to an inhaled corticosteroid less affected by CYP3A4, such as beclomethasone. Monitor ECG and for corticosteroid excess if unavoidable.
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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