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Fluticasone-salmeterol + Lopinavir

Gravità: Controindicata

Fluticasone-salmeterol and Lopinavir: contraindicated interaction.

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Sintesi

Lopinavir/ritonavir strongly inhibits CYP3A4 and can greatly increase salmeterol exposure, with risk of QT prolongation and arrhythmias. Systemic fluticasone exposure also rises, which can lead to Cushing's syndrome and adrenal suppression.

Cosa significa questa interazione in parole semplici

Fluticasone-salmeterol and Lopinavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Fluticasone-salmeterol belongs to Respiratory; Lopinavir belongs to Anti Virals.

Livello di evidenza: High

Perché avviene

Strong CYP3A4 inhibition reduces clearance of salmeterol and fluticasone.

Cosa fare

Avoid the combination and switch to an alternative such as beclomethasone with a different LABA. If unavoidable, monitor ECG, potassium and adrenal function.

Cosa chiedere al farmacista

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Domande frequenti

Can I take Fluticasone-salmeterol with Lopinavir?

MediHelp rates the interaction as contraindicated. Fluticasone-salmeterol and Lopinavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Lopinavir/ritonavir strongly inhibits CYP3A4 and can greatly increase salmeterol exposure, with risk of QT prolongation and arrhythmias. Systemic fluticasone exposure also rises, which can lead to Cushing's syndrome and adrenal suppression.

How serious is the interaction between Fluticasone-salmeterol and Lopinavir?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and switch to an alternative such as beclomethasone with a different LABA. If unavoidable, monitor ECG, potassium and adrenal function.

What other medicines interact with Fluticasone-salmeterol?

MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Fosamprenavir. The full list is on the Fluticasone-salmeterol page.

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