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Interacting Drugs

OBJECT DRUGS

Corticosteroids:

PRECIPITANT DRUGS

Enzyme Inhibitors:


Comment:

Inhibition of CYP3A4 may result in substantial increases in the plasma concentrations of these corticosteroids, even when the corticosteroids are given nasally or by inhalation. This can lead to Cushing's syndrome and adrenal suppression. For example, ritonavir was found to dramatically increase plasma fluticasone concentrations, accompanied by marked suppression of endogenous cortisol production. Although inhaled budesonide or fluticasone are not intended to act systemically, numerous cases have appeared of Cushing's syndrome and adrenal insufficiency due to concurrent use of a potent CYP3A4 inhibitor.


Class 3: Assess Risk & Take Action if Necessary