Drug interactions
Nefazodone + Salmeterol
Severity: Major
Nefazodone and Salmeterol: 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
Nefazodone is a potent CYP3A4 inhibitor and may markedly raise salmeterol concentrations. This can lead to excess beta-agonist effects such as tachycardia, tremor, hypokalemia and QT prolongation.
What this interaction means in plain words
Nefazodone and Salmeterol 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
Inhibition of CYP3A4-mediated salmeterol metabolism increases systemic exposure.
What to do
Avoid the combination if possible and use an alternative bronchodilator. If coadministered, monitor heart rate, ECG and potassium.
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 Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol Major
Frequently asked questions
Can I take Nefazodone with Salmeterol?
MediHelp rates the interaction as major. Nefazodone and Salmeterol 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. Nefazodone is a potent CYP3A4 inhibitor and may markedly raise salmeterol concentrations. This can lead to excess beta-agonist effects such as tachycardia, tremor, hypokalemia and QT prolongation.
How serious is the interaction between Nefazodone and Salmeterol?
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 if possible and use an alternative bronchodilator. If coadministered, monitor heart rate, ECG and potassium.
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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