Salmeterol/Cobicistat; Protease Inhibitors Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Although most of your salmeterol is inhaled into your lungs, some of the medicine is swallowed. Your protease inhibitor slows down how quickly your liver processes the portion of the medicine that is swallowed.
What might happen:
The amount of salmeterol in your blood may increase and cause changes in your heart's rhythm, which may be life-threatening.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you notice a fast and/or irregular heartbeat or have any dizziness or fainting episodes. Be sure to rinse your mouth after using your inhaler to limit the amount of medicine you swallow.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Serevent Diskus (salmeterol xinafoate) US prescribing information. SmithKline Beecham Corporation December, 2010.
- 2.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company November, 2023.
- 3.Victrelis (boceprevir) US prescribing information. Schering Corporation January, 2017.
- 4.Prezista (darunavir) US prescribing information. Janssen Therapeutics March, 2023.
- 5.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline March, 2019.
- 6.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. September, 2016.
- 7.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories December, 2019.
- 8.Viracept (nelfinavir mesylate) US prescribing information. Agouron Pharmaceuticals, Inc. September, 2016.
- 9.Norvir (ritonavir) US prescribing information. Abbott Laboratories December, 2019.
- 10.Invirase (saquinavir mesylate) US prescribing information. Roche Laboratories, Inc. March, 2019.
- 11.Incivek (telaprevir) US prescribing information. Vertex Pharmaceuticals Incorporated October, 2013.
- 12.Aptivus (tipranavir) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. June, 2020.
- 13.Tybost (cobicistat) US prescribing information. Gilead Sciences, Inc. September, 2021.
- 14.Paxlovid (nirmatrelvir tablets and ritonavir tablets) US prescribing information. Pfizer Inc. May, 2023.
- 15.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
- 16.National Institutes of Health. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Available at https://www.covid19treatmentguidelines.nih.gov/ Accessed July 5, 2022.
- 17.Advair (fluticasone propionate/salmeterol) Canadian prescribing information. GlaxoSmithKline May 20, 2011.
- 18.Kaletra (lopinavir/ritonavir) Canadian prescribing information. Abbott Limited May 22, 2019.
- 19.Paxlovid (nirmatrelvir tablets and ritonavir tablets) Canadian Product Monograph. Pfizer Canada ULC December 8, 2022.
- 20.Norvir (ritonavir) Canadian prescribing information. Abbott May 29, 2019.
- 21.Manchee GR, Eddershaw PJ, Ranshaw LE, Herriott D, Park GR, Bayliss MK, Tarbit MH. The aliphatic oxidation of salmeterol to alpha-hydroxysalmeterol in human liver microsomes is catalyzed by CYP3A. Drug Metab Dispos 1996 May;24(5):555-9.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.