Drug interactions
Fluticasone-salmeterol + Ritonavir
Severity: Contraindicated
Fluticasone-salmeterol and Ritonavir: contraindicated 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 is a potent CYP3A4 inhibitor that markedly increases salmeterol exposure, leading to QT prolongation, tachycardia and arrhythmias. It also substantially raises systemic fluticasone levels, and cases of Cushing's syndrome and adrenal suppression have been reported.
What this interaction means in plain words
Fluticasone-salmeterol and Ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Fluticasone-salmeterol belongs to Respiratory; Ritonavir belongs to Anti Virals.
Why it happens
Potent CYP3A4 inhibition by ritonavir reduces clearance of salmeterol and fluticasone.
What to do
Avoid the combination and use an alternative such as beclomethasone or another non-CYP3A4-dependent regimen. If unavoidable, monitor ECG, potassium and adrenal function.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Fluticasone-salmeterol with Ritonavir?
MediHelp rates the interaction as contraindicated. Fluticasone-salmeterol and Ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ritonavir is a potent CYP3A4 inhibitor that markedly increases salmeterol exposure, leading to QT prolongation, tachycardia and arrhythmias. It also substantially raises systemic fluticasone levels, and cases of Cushing's syndrome and adrenal suppression have been reported.
How serious is the interaction between Fluticasone-salmeterol and Ritonavir?
MediHelp rates it contraindicated, 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 such as beclomethasone or another non-CYP3A4-dependent regimen. If unavoidable, monitor ECG, potassium and adrenal function.
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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