Drug interactions
Fluticasone-vilanterol + Ketoconazole
Severity: Major
Fluticasone-vilanterol and Ketoconazole: 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
Ketoconazole is a strong CYP3A4 inhibitor and raises systemic exposure to fluticasone furoate and vilanterol. This can increase corticosteroid effects including cortisol suppression, and beta-agonist cardiovascular effects such as tachycardia, palpitations and hypokalemia.
What this interaction means in plain words
Fluticasone-vilanterol and Ketoconazole 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-vilanterol belongs to Respiratory; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 and P-gp inhibition reduces first-pass and systemic metabolism of fluticasone furoate and vilanterol.
What to do
Avoid the combination where possible, or use with caution and monitor for systemic corticosteroid effects and cardiovascular beta-agonist effects including heart rate and potassium. Consider an alternative inhaler or antifungal.
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-vilanterol
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Fluticasone-vilanterol with Ketoconazole?
MediHelp rates the interaction as major. Fluticasone-vilanterol and Ketoconazole 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. Ketoconazole is a strong CYP3A4 inhibitor and raises systemic exposure to fluticasone furoate and vilanterol. This can increase corticosteroid effects including cortisol suppression, and beta-agonist cardiovascular effects such as tachycardia, palpitations and hypokalemia.
How serious is the interaction between Fluticasone-vilanterol and Ketoconazole?
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, or use with caution and monitor for systemic corticosteroid effects and cardiovascular beta-agonist effects including heart rate and potassium. Consider an alternative inhaler or antifungal.
What other medicines interact with Fluticasone-vilanterol?
MediHelp also lists interactions of Fluticasone-vilanterol with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Fluticasone-vilanterol page.
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