Nasoflo Drug Interactions

Concomitant use with other inhaled or systemic corticosteroids may increase the risk of hypercorticism and/or suppression of HPA axis function.
Since fluticasone propionate is metabolized in the liver by the cytochrome P-450 (CYP) 3A4 isoenzyme, concomitant use of drugs that affect CYP hepatic microsomal enzymes may alter fluticasone's metabolism. Concomitant use of intranasal fluticasone propionate (200 mcg once daily) and ritonavir (100 mcg twice daily) may increase peak plasma concentrations and area under the plasma concentration-time curve (AUC) of fluticasone, resulting in decreased plasma cortisol AUC. During postmarketing experience, Cushing syndrome and adrenal suppression have been reported in patients receiving concomitant therapy of fluticasone propionate and ritonavir. Thus, concomitant use of these drugs is not recommended unless the potential benefit justifies the risk of systemic corticosteroid adverse effects.
Concurrent administration with ketoconazole may increase plasma fluticasone concentrations, reduce plasma cortisol AUC, and no effect on urinary excretion of cortisol.
Exercise caution when fluticasone is co-administered with other potent CYP3A4 inhibitors.