Drug interactions
Istradefylline + Salmeterol
Severity: Moderate
Istradefylline and Salmeterol: 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
Istradefylline at 40 mg/day raises exposure to CYP3A4 substrates, which may increase salmeterol levels. Increased levels can cause tachycardia, tremor, hypokalemia and QT prolongation. The effect was not seen at 20 mg/day.
What this interaction means in plain words
Istradefylline and Salmeterol 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.
Istradefylline belongs to Central Nervous System; Salmeterol belongs to Respiratory.
Why it happens
Istradefylline at higher doses inhibits CYP3A4, decreasing salmeterol metabolism.
What to do
Monitor for beta-agonist adverse effects such as palpitations and tremor, particularly if istradefylline 40 mg/day is used. Consider the lower istradefylline dose or review salmeterol need if symptoms occur.
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?
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Other interactions of Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol Major
Other interactions of Istradefylline
Frequently asked questions
Can I take Istradefylline with Salmeterol?
MediHelp rates the interaction as moderate. Istradefylline and Salmeterol 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. Istradefylline at 40 mg/day raises exposure to CYP3A4 substrates, which may increase salmeterol levels. Increased levels can cause tachycardia, tremor, hypokalemia and QT prolongation. The effect was not seen at 20 mg/day.
How serious is the interaction between Istradefylline and Salmeterol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for beta-agonist adverse effects such as palpitations and tremor, particularly if istradefylline 40 mg/day is used. Consider the lower istradefylline dose or review salmeterol need if symptoms occur.
What other medicines interact with Salmeterol?
MediHelp also lists interactions of Salmeterol with, for example, Ritonavir, Saquinavir, Amitriptyline. The full list is on the Salmeterol page.
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