Drug interactions
Fosaprepitant + Hydrocortisone
Severity: Moderate
Fosaprepitant and Hydrocortisone: moderate 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
Fosaprepitant is converted to aprepitant, a moderate CYP3A4 inhibitor, which can raise exposure to corticosteroids that are CYP3A4 substrates. Hydrocortisone is cleared partly by CYP3A4, so systemic steroid effects may be modestly enhanced. The effect is usually small after a single dose of fosaprepitant.
What this interaction means in plain words
Fosaprepitant and Hydrocortisone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fosaprepitant belongs to Gastrointestinal Tract; Hydrocortisone belongs to Endocrine.
Why it happens
Aprepitant, the active metabolite of fosaprepitant, inhibits CYP3A4 and reduces hydrocortisone clearance.
What to do
With repeated or prolonged hydrocortisone therapy, watch for excess glucocorticoid effects such as hyperglycemia, fluid retention and hypertension. Reduce the dose of oral or intravenous hydrocortisone if these appear.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fosaprepitant and Hydrocortisone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone Major
Other interactions of Fosaprepitant
- Flibanserin + Fosaprepitant Contraindicated
- Fosaprepitant + Pimozide Contraindicated
- Alprazolam + Fosaprepitant Moderate
- Amiodarone + Fosaprepitant Moderate
- Amobarbital + Fosaprepitant Moderate
- Apalutamide + Fosaprepitant Moderate
Frequently asked questions
Can I take Fosaprepitant with Hydrocortisone?
MediHelp rates the interaction as moderate. Fosaprepitant and Hydrocortisone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fosaprepitant is converted to aprepitant, a moderate CYP3A4 inhibitor, which can raise exposure to corticosteroids that are CYP3A4 substrates. Hydrocortisone is cleared partly by CYP3A4, so systemic steroid effects may be modestly enhanced. The effect is usually small after a single dose of fosaprepitant.
How serious is the interaction between Fosaprepitant and Hydrocortisone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: With repeated or prolonged hydrocortisone therapy, watch for excess glucocorticoid effects such as hyperglycemia, fluid retention and hypertension. Reduce the dose of oral or intravenous hydrocortisone if these appear.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
