Drug interactions
Fluticasone-salmeterol + Saquinavir
Severity: Major
Fluticasone-salmeterol and Saquinavir: 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
Saquinavir, usually given with ritonavir, strongly inhibits CYP3A4 and can markedly raise systemic fluticasone levels. This may cause Cushing's syndrome and adrenal suppression. Salmeterol exposure is also increased, which raises the risk of QT prolongation and cardiovascular effects.
What this interaction means in plain words
Fluticasone-salmeterol and Saquinavir 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 by saquinavir reduces the first-pass and systemic metabolism of fluticasone and salmeterol.
What to do
Avoid the combination where possible and consider an alternative inhaled corticosteroid such as beclomethasone. If it cannot be avoided, monitor for corticosteroid excess, ECG changes and arrhythmia.
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 Saquinavir?
MediHelp rates the interaction as major. Fluticasone-salmeterol and Saquinavir 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. Saquinavir, usually given with ritonavir, strongly inhibits CYP3A4 and can markedly raise systemic fluticasone levels. This may cause Cushing's syndrome and adrenal suppression. Salmeterol exposure is also increased, which raises the risk of QT prolongation and cardiovascular effects.
How serious is the interaction between Fluticasone-salmeterol and Saquinavir?
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 where possible and consider an alternative inhaled corticosteroid such as beclomethasone. If it cannot be avoided, monitor for corticosteroid excess, ECG changes and arrhythmia.
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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