Drug interactions
Posaconazole + Salmeterol
Severity: Major
Posaconazole 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
Posaconazole is a strong CYP3A4 inhibitor and can markedly raise systemic salmeterol exposure. This increases the risk of QT prolongation, palpitations, tachycardia, tremor and hypokalemia, and posaconazole itself prolongs QT.
What this interaction means in plain words
Posaconazole 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.
Posaconazole belongs to Anti Fungals; Salmeterol belongs to Respiratory.
Why it happens
Inhibition of CYP3A4-mediated metabolism of salmeterol, increasing its systemic concentrations, with additive QT effects.
What to do
Avoid the combination where possible, or use an alternative long-acting beta agonist less dependent on CYP3A4. If it is used, monitor ECG, heart rate and serum 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
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Posaconazole with Salmeterol?
MediHelp rates the interaction as major. Posaconazole 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. Posaconazole is a strong CYP3A4 inhibitor and can markedly raise systemic salmeterol exposure. This increases the risk of QT prolongation, palpitations, tachycardia, tremor and hypokalemia, and posaconazole itself prolongs QT.
How serious is the interaction between Posaconazole 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 where possible, or use an alternative long-acting beta agonist less dependent on CYP3A4. If it is used, monitor ECG, heart rate and serum 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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