aerobid-m and Fosamprenavir Interactions

Interactions between aerobid-m(flunisolide) and Fosamprenavir (fosamprenavir)

flunisolide and fosamprenavir (Moderate Drug-Drug)

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations and pharmacologic effects of corticosteroids, which are primarily metabolized by the isoenzyme. The interaction has been reported with potent inhibitors such as clarithromycin, erythromycin, itraconazole, nefazodone, and ritonavir during concomitant use of various corticosteroids, including inhaled formulations. Cushing's syndrome and adrenal insufficiency have been attributed to the interaction.

MANAGEMENT: The possibility of increased corticosteroid effects should be considered during concomitant therapy with CYP450 3A4 inhibitors, particularly potent ones like itraconazole, ketoconazole, voriconazole, nefazodone, protease inhibitors, and ketolide and macrolide antibiotics. Adrenal function should be monitored regularly during chronic use of these agents, and corticosteroid dosage adjusted as necessary. Adverse effects during prolonged administration of corticosteroids may include symptoms of hypercorticism (e.g., acne, easy bruising, moon face, edema, hirsutism, buffalo hump, skin striae, glucose intolerance, irregular menstruations); adrenal suppression (which reduces patient's ability to respond to stress situations); immunosuppression; and osteoporosis.