Interações medicamentosas
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone-salmeterol
Gravidade: Contraindicada
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone-salmeterol: contraindicated interaction.
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Resumo
Cobicistat is a strong CYP3A4 inhibitor that increases salmeterol exposure, with risk of QT prolongation and arrhythmia. It also raises systemic fluticasone levels, so Cushing's syndrome and adrenal suppression can occur with prolonged use.
O que esta interação significa em palavras simples
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone-salmeterol 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.
Por que acontece
Strong CYP3A4 inhibition by cobicistat reduces clearance of salmeterol and fluticasone.
O que fazer
Avoid the combination and consider an alternative such as beclomethasone with a non-CYP3A4-dependent LABA. If it cannot be avoided, monitor ECG, potassium and adrenal function.
O que perguntar ao farmacêutico
- 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?
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Outras interações de Fluticasone-salmeterol
- Darunavir + Fluticasone-salmeterol Contraindicada
- Fluticasone-salmeterol + Fosamprenavir Contraindicada
- Fluticasone-salmeterol + Indinavir Contraindicada
- Fluticasone-salmeterol + Lopinavir Contraindicada
- Fluticasone-salmeterol + Nelfinavir Contraindicada
- Fluticasone-salmeterol + Ritonavir Contraindicada
Perguntas frequentes
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Fluticasone-salmeterol?
MediHelp rates the interaction as contraindicated. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone-salmeterol 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. Cobicistat is a strong CYP3A4 inhibitor that increases salmeterol exposure, with risk of QT prolongation and arrhythmia. It also raises systemic fluticasone levels, so Cushing's syndrome and adrenal suppression can occur with prolonged use.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone-salmeterol?
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 consider an alternative such as beclomethasone with a non-CYP3A4-dependent LABA. If it cannot be avoided, monitor ECG, potassium and adrenal function.
What other medicines interact with Fluticasone-salmeterol?
MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Fosamprenavir, Indinavir. The full list is on the Fluticasone-salmeterol page.
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